Individual provider Active NPI

Lida Cako, APRN

  • Nurse Practitioner
  • Daytona Beach, FL
National Provider Identifier
1982414702
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11038863 Issued in FL
Practice address
305 Memorial Medical Pkwy Ste 501
Daytona Beach, FL 32117-5170
Phone
(386) 615-0900
Fax
(386) 615-0902
NPI assigned
Jan 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9497116 FL
Nurse Practitioner 363L00000X APRN11038863 FL Primary

Addresses

Primary practice location

305 Memorial Medical Pkwy Ste 501
Daytona Beach, FL 32117-5170

Mailing address

305 Memorial Medical Pkwy Ste 501
Daytona Beach, FL 32117-5170
Phone (386) 615-0900

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
I20250822003536 FL Practitioner - Nurse Practitioner 1254831340 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)

305 Memorial Medical Pkwy
Suite 501
Daytona Beach, FL 32117-5157

6280 Bahama CT
Fleming Island, FL 32003-8059

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9497116FLMDRegistered Nurse
APRN11038863FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Sleep and Respiratory Institute, P.a. CurrentSince Jul 1, 2025 Accepting new patients
Advanced Heart Group PL PastSince Jul 1, 2025 Accepting new patients

Locations

4721 E Moody Blvd
Ste 104
Bunnell, FL 32110
Phone (386) 586-1229

305 Memorial Medical Pkwy
Ste 501
Daytona Beach, FL 32117
Phone 3866150900209

3 Pine Cone Dr
Ste 106
Palm Coast, FL 32137
Phone (386) 585-4463

4883 Palm Coast Pkwy NW
Unit 5
Palm Coast, FL 32137
Phone (386) 585-4463

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, 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": "1736726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1982414702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 MEMORIAL MEDICAL PKWY STE 501",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175170",
            "telephone_number": "386-615-0900",
            "fax_number": "386-615-0902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MEMORIAL MEDICAL PKWY STE 501",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175170",
            "telephone_number": "386-615-0900",
            "fax_number": "386-615-0902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAKO",
        "first_name": "LIDA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-13",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9497116",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11038863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.