Individual provider Active NPI

Sierra M Quintero, APRN

  • Family Nurse Practitioner
  • Daytona Beach, FL
National Provider Identifier
1972140994
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11005138 Issued in FL
Practice address
311 N Clyde Morris Blvd Ste 320
Daytona Beach, FL 32114-2756
Phone
(386) 255-5331
NPI assigned
Dec 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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 11005138 FL Primary

Addresses

Primary practice location

311 N Clyde Morris Blvd Ste 320
Daytona Beach, FL 32114-2756

Mailing address

311 N Clyde Morris Blvd Ste 320
Daytona Beach, FL 32114-2756
Phone (386) 255-5331

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
I20230424000391 FL Practitioner - Nurse Practitioner 8527423755 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11005138FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiology Physicians, P.a. CurrentSince Mar 15, 2023 Accepting new patients

Locations

311 N Clyde Morris Blvd
Ste 320
Daytona Beach, FL 32114
Phone (386) 255-5331

Organizations & group practices 1

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": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1972140994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 N CLYDE MORRIS BLVD STE 320",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142756",
            "telephone_number": "386-255-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N CLYDE MORRIS BLVD STE 320",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142756",
            "telephone_number": "386-255-5331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTERO",
        "first_name": "SIERRA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-09",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11005138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.