Individual provider Active NPI

Keila Fonseca

  • Family Nurse Practitioner
  • Royal Palm Beach, FL
National Provider Identifier
1962218503
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11036579 Issued in FL
Practice address
1117 Royal Palm Beach Blvd
Royal Palm Beach, FL 33411-1641
Phone
(561) 920-9500
NPI assigned
Dec 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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 11036579 FL Primary

Addresses

Primary practice location

1117 Royal Palm Beach Blvd
Royal Palm Beach, FL 33411-1641

Mailing address

388 Park Forest Way
Wellington, FL 33414-4976
Phone (561) 920-9500

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
I20250930003067 FL Practitioner - Nurse Practitioner 7618473513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

388 Park Forest Way
Weillington, FL 33414-4976

Hospital & facility affiliations

  • Paramount Home Care Agency, Inc. Home health agency, Palm Beach Gardens, FL, CCN 687140
  • Simply Home Health Care LLC Home health agency, Lake Worth, FL, CCN 687166

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11036579FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Skye Medical LLC CurrentSince May 31, 2026 Accepting new patients
Montesol Medical Centers LLC CurrentSince Aug 25, 2025 Accepting new patients

Locations

1117 Royal Palm Beach Blvd
Royal Palm Beach, FL 33411
Phone (561) 252-5826

2669 Forest Hill Blvd
Ste 100
West Palm Beach, FL 33406
Phone (561) 968-7600

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 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": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1962218503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 PARK FOREST WAY",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144976",
            "telephone_number": "561-920-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 ROYAL PALM BEACH BLVD",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334111641",
            "telephone_number": "561-920-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONSECA",
        "first_name": "KEILA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-09",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11036579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.