Individual provider Active NPI

Carmen Caridad Leal Diaz

  • Psychiatric/Mental Health Nurse Practitioner
  • Homestead, FL
National Provider Identifier
1871108480
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11006637 Issued in FL
Practice address
547 SE 33Rd Ter
Homestead, FL 33033-5955
Phone
(305) 244-6868
NPI assigned
Sep 10, 2020
Last updated
Feb 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11006637 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11006637 FL Primary

Addresses

Primary practice location

547 SE 33Rd Ter
Homestead, FL 33033-5955

Mailing address

547 SE 33Rd Ter
Homestead, FL 33033-5955
Phone (305) 244-6868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210625002249 FL Practitioner - Nurse Practitioner 4284035338 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Behavioral Centers of South FloridaGroup PAC ID 7214355981, 5 clinicians

Practice addresses (Care Compare)

1806 N Flamingo Rd
Suite 280
Pembroke Pines, FL 33028-1031
Phone (954) 866-1202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11006637FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Loyalty Medical Group LLC Psychiatric/Mental Health Current Accepting new patients
Behavioral Centers of South Florida CurrentSince Jun 2, 2021 Accepting new patients
Behavior Support Center of Florida Inc CurrentSince Apr 14, 2025 Accepting new patients

Locations

13980 SW 47th St
Miami, FL 33175
Phone (305) 772-4405

15305 NW 60th Ave
Ste 100
Miami Lakes, FL 33014
Phone (786) 536-7561

1806 N Flamingo Rd
Ste 280
Pembroke Pines, FL 33028
Phone (305) 854-5631

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1871108480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 SE 33RD TER",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330335955",
            "telephone_number": "305-244-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "547 SE 33RD TER",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330335955",
            "telephone_number": "305-244-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAL DIAZ",
        "first_name": "CARMEN",
        "middle_name": "CARIDAD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-10",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11006637",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11006637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

Verify at the official NPI Registry.