Individual provider Active NPI

Lilian Silva Carlisle, ARNP

  • Adult Health Nurse Practitioner
  • Fort Lauderdale, FL
National Provider Identifier
1932655529
Registry record updated Jan 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP9294282 Issued in FL
Practice address
2122 NW 62ND St Ste 110
Fort Lauderdale, FL 33309-1866
Phone
(954) 353-3180
Fax
(954) 353-3185
NPI assigned
Sep 1, 2016
Last updated
Jan 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP9294282 FL Primary
Gerontology Nurse Practitioner 363LG0600X ARNP9294282 FL
Primary Care Nurse Practitioner 363LP2300X ARNP9294282 FL

Addresses

Primary practice location

2122 NW 62ND St Ste 110
Fort Lauderdale, FL 33309-1866

Mailing address

4780 SW 64TH Ave Ste 103
Davie, FL 33314-4400
Phone (954) 434-1800

Other practice location 1

9970 Central Park Blvd N Ste 404
Boca Raton, FL 33428-2236
Phone (561) 483-1125

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
I20181128001530 FL Practitioner - Nurse Practitioner 3870837156 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP9294282FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Associatesmd Medical Group Inc CurrentSince Feb 1, 2020 Accepting new patients
Associatesmd Medical Group Inc CurrentSince Feb 1, 2020 Accepting new patients

Locations

4780 SW 64th Ave
Davie, FL 33314

4780 SW 64th Ave
Ste 101
Davie, FL 33314

4780 SW 64th Ave
Ste 103
Davie, FL 33314

2122 W Cypress Creek Rd
Ste 110
Ft Lauderdale, FL 33309
Phone (954) 353-3180

2004 N Flamingo Rd
Pembroke Pnes, FL 33028
Phone (954) 450-8500

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.

NPI Registry JSON

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579564800000",
    "number": "1932655529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4780 SW 64TH AVE STE 103",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333144400",
            "telephone_number": "954-434-1800",
            "fax_number": "800-642-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 NW 62ND ST STE 110",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333091866",
            "telephone_number": "954-353-3180",
            "fax_number": "954-353-3185"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9970 Central Park Blvd N Ste 404",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334282236",
            "country_code": "US",
            "telephone_number": "561-483-1125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "LILIAN",
        "middle_name": "SILVA",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9294282",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "ARNP9294282",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "ARNP9294282",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.