Individual provider Active NPI

Mini V Kuriakose, NP-C

  • Nurse Practitioner
  • Plantation, FL
National Provider Identifier
1912406315
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9255817 Issued in FL
Practice address
8320 W Sunrise Blvd Ste 405
Plantation, FL 33322-5435
Phone
(800) 640-3451
NPI assigned
Feb 12, 2018
Last updated
Oct 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9255817 FL Primary

Addresses

Primary practice location

8320 W Sunrise Blvd Ste 405
Plantation, FL 33322-5435

Mailing address

PO Box 1200
Pleasant Grove, UT 84062-1200
Phone (800) 640-3451

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
I20180926000911 FL Practitioner - Nurse Practitioner 6507117801 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
Spencer J Hardenbrook MD PCGroup PAC ID 2062733546, 93 clinicians

Practice addresses (Care Compare)

8320 W Sunrise Blvd
Suite 208
Plantation, FL 33322-5432
Phone (800) 640-3451

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9255817FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spencer J Hardenbrook MD PC CurrentSince Oct 1, 2024 Accepting new patients
Wound Technology Network Inc CurrentSince May 7, 2018 Accepting new patients

Locations

5979 Vineland Rd
Ste 109
Orlando, FL 32819
Phone (407) 270-7702

8320 W Sunrise Blvd
Ste 208
Plantation, FL 33322
Phone (904) 203-8853

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1912406315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1200",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840621200",
            "telephone_number": "800-640-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8320 W SUNRISE BLVD STE 405",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333225435",
            "telephone_number": "800-640-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURIAKOSE",
        "first_name": "MINI",
        "middle_name": "V",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-12",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9255817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.