LUIS MANUEL VANDAMA BRIZUELA APRN
NPI 1104449644
Nurse Practitioner - Family in Pembroke Pines, FL

Q: What is Luis Vandama Brizuela's NPI number?

The NPI number for Luis Vandama Brizuela is 1104449644. It was assigned to this individual provider in the NPPES registry on May 19, 2020.

Q: What is Luis Vandama Brizuela's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since May 19, 2020PECOS Enrolled

1500 S HIATUS RD, PEMBROKE PINES, FL 33025(954) 438-4000(786) 791-1270 Get Directions Write a Review

NPPES record last updated: May 12, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 12, 2025, May 8, 2025, May 19, 2020 (3 updates tracked since 2020).

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About Luis Manuel Vandama Brizuela Aprn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LUIS MANUEL VANDAMA BRIZUELA APRN (NPI 1104449644) is an individual family provider in Pembroke Pines, Florida, licensed in Florida (APRN11007011) and active in the NPI registry since May 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104449644

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameLUIS MANUEL VANDAMA BRIZUELACredential: APRN

Location Address1500 S HIATUS RDPembroke Pines, FL 33025-3617

Mailing Address1500 S Hiatus RdPembroke Pines, FL 33025-3617 · (954) 438-4000 · Fax (786) 791-1270

Phone(954) 438-4000

Fax(786) 791-1270

Sole ProprietorNo

Enumeration DateMay 19, 2020

Last NPPES UpdateMay 12, 20253 updates tracked since enumeration

NPPES CertifiedMay 12, 2025

✔ NPI 1104449644 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in FL · APRN11007011

1500 S HIATUS RD, Pembroke Pines, FL 33025

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Luis Manuel Vandama Brizuela Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33025 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$91.69 typical visit price

range $58.56 – $179.05

Typical copayment $22.92 (range $14.64 – $44.76)

Most-billed visit code 99203

Established Patient

$103.21 typical visit price

range $18.44 – $144.68

Typical copayment $25.80 (range $4.61 – $36.17)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PASTEUR & WELLMAX MEDICAL CENTERS LLC

Internal Medicine (Geriatric Medicine)