Individual provider Active NPI

Leticia Noemi Anon, APRN

  • Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1982186201
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9301728 Issued in FL
Practice address
160 S Flamingo Rd
Pembroke Pines, FL 33027-1720
Phone
(954) 620-0011
Fax
(954) 620-0238
NPI assigned
Sep 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN9301728 FL Primary

Addresses

Primary practice location

160 S Flamingo Rd
Pembroke Pines, FL 33027-1720

Mailing address

160 S Flamingo Rd
Pembroke Pines, FL 33027-1720
Phone (954) 620-0011

Other identifiers 1

IdentifierTypeStateIssuer
104365100MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address leticia-anon@alexmlammdpa.e-mdsdirect.com

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
I20191107002027 FL Practitioner - Nurse Practitioner 3779915038 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Institute for Rheumatology & Integrative Medicine CurrentSince Aug 1, 2019 Accepting new patients

Locations

160 S Flamingo Rd
Pembroke Pines, FL 33027
Phone (954) 620-0011

600 N Hiatus Rd
Ste 105
Pembroke Pines, FL 33026
Phone (954) 620-0011

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": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1982186201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 S FLAMINGO RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271720",
            "telephone_number": "954-620-0011",
            "fax_number": "954-620-0238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 S FLAMINGO RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271720",
            "telephone_number": "954-620-0011",
            "fax_number": "954-620-0238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANON",
        "first_name": "LETICIA",
        "middle_name": "NOEMI",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-04",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9301728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104365100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "leticia-anon@alexmlammdpa.e-mdsdirect.com",
            "affiliation": "N",
            "address_1": "160 S Flamingo Rd",
            "city": "Pembroke Pines",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330271720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.