Individual provider Active NPI

Roberto Carlos Porras, APRN

  • Family Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1972375020
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11010588 Issued in FL
Practice address
717 NW 135TH Ave
Pembroke Pines, FL 33028-3157
Phone
(786) 223-6680
NPI assigned
Oct 23, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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 11010588 FL Primary

Addresses

Primary practice location

717 NW 135TH Ave
Pembroke Pines, FL 33028-3157

Mailing address

717 NW 135TH Ave
Pembroke Pines, FL 33028-3157
Phone (786) 223-6680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11010588FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1972375020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 NW 135TH AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330283157",
            "telephone_number": "786-223-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 NW 135TH AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330283157",
            "telephone_number": "786-223-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORRAS",
        "first_name": "ROBERTO",
        "middle_name": "CARLOS",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11010588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.