Individual provider Active NPI

Kristen Lee Milinazzo

  • Gerontology Nurse Practitioner
  • Brandon, FL
National Provider Identifier
1881173672
Registry record updated Aug 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
ARNP9229848 Issued in FL
Practice address
402 Noland Dr
Brandon, FL 33511-5709
Phone
(813) 655-2500
NPI assigned
Aug 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X ARNP9229848 FL Primary

Addresses

Primary practice location

402 Noland Dr
Brandon, FL 33511-5709

Mailing address

402 Noland Dr
Brandon, FL 33511-5709

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
I20190906001543 FL Practitioner - Nurse Practitioner 1951630532 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Physician Services of Florida PAGroup PAC ID 7012201965, 212 clinicians

Practice addresses (Care Compare)

200 Ave F NE
Winter Haven, FL 33881-4131
Phone (863) 293-1121

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9229848FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Care Hospitalists PL CurrentSince Feb 4, 2020 Accepting new patients
Hospital Physician Services of Florida PA CurrentSince Aug 7, 2020 Accepting new patients

Locations

4315 Highland Park Blvd
Ste D
Lakeland, FL 33813
Phone (863) 816-5884

4315 Highland Park Blvd
Ste A
Lakeland, FL 33813
Phone (813) 651-1085

8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212

200 Avenue F NE
Winter Haven, FL 33881
Phone (863) 292-4652

Organizations & group practices 2

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1881173672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 NOLAND DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 NOLAND DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115709",
            "telephone_number": "813-655-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILINAZZO",
        "first_name": "KRISTEN",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "ARNP9229848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.