Individual provider Active NPI

Juan Antonio Casanova Hidalgo, FNP

  • Family Nurse Practitioner
  • Miami Lakes, FL
National Provider Identifier
1881292217
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11009700 Issued in FL
Practice address
8145 NW 155TH St Ste B
Miami Lakes, FL 33016-5872
Phone
(305) 698-5300
NPI assigned
Oct 16, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9423575 FL
Family Nurse Practitioner 363LF0000X 11009700 FL Primary

Addresses

Primary practice location

8145 NW 155TH St Ste B
Miami Lakes, FL 33016-5872

Mailing address

8145 NW 155TH St Ste B
Miami Lakes, FL 33016-5872
Phone (305) 698-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9423575FLMDRegistered Nurse
11009700FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier OBGYN of South Florida PLLC CurrentSince Sep 1, 2024 Accepting new patients
Premier OBGYN of South Florida PLLC CurrentSince Sep 1, 2024 Accepting new patients

Locations

8145 NW 155th St
#B
Miami Lakes, FL 33016
Phone (305) 698-5300

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.

NPI Registry JSON

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

{
    "created_epoch": "1602806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1881292217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8145 NW 155TH ST STE B",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165872",
            "telephone_number": "305-698-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8145 NW 155TH ST STE B",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165872",
            "telephone_number": "305-698-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASANOVA HIDALGO",
        "first_name": "JUAN",
        "middle_name": "ANTONIO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-16",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9423575",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11009700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.