Individual provider Active NPI

Winston Odel Guevara

  • Family Nurse Practitioner
  • Boynton Beach, FL
National Provider Identifier
1932674785
Registry record updated Jul 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11000581 Issued in FL
Practice address
2828 S Seacrest Blvd Ste 216
Boynton Beach, FL 33435-7944
Phone
(561) 734-5080
Fax
(561) 395-3098
NPI assigned
Oct 9, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11000581 FL Primary

Addresses

Primary practice location

2828 S Seacrest Blvd Ste 216
Boynton Beach, FL 33435-7944

Mailing address

2828 S Seacrest Blvd Ste 216
Boynton Beach, FL 33435-7944
Phone (561) 734-5080

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
I20200303000235 FL Practitioner - Nurse Practitioner 2567899669 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialist Consultation Network LLCGroup PAC ID 3375076557, 5 clinicians

Practice addresses (Care Compare)

737 NW 135TH Ave
Pembroke Pines, FL 33028-3157
Phone (786) 200-7553

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11000581FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Awais K Humayun MD PA CurrentSince Nov 12, 2021 Accepting new patients
Lumina Wellness Group LLC Family CurrentSince Dec 31, 2024 Accepting new patients
Specialist Consultation Network LLC CurrentSince Sep 17, 2024 Accepting new patients

Locations

4801 S University Dr
Ste 104
Davie, FL 33328

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

Organizations & group practices 4

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": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1932674785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 S SEACREST BLVD STE 216",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334357944",
            "telephone_number": "561-734-5080",
            "fax_number": "561-395-3098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 S SEACREST BLVD STE 216",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334357944",
            "telephone_number": "561-734-5080",
            "fax_number": "561-395-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUEVARA",
        "first_name": "WINSTON",
        "middle_name": "ODEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-09",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11000581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.