Individual provider Active NPI

Ariadna Gonzalez Bermudez

  • Clinical Social Worker
  • Hialeah, FL
National Provider Identifier
1013419183
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW22064 Issued in FL
Practice address
18300 NW 62ND Ave Ste 200
Hialeah, FL 33015-8207
Phone
(786) 304-7731
Fax
(786) 353-2349
NPI assigned
Mar 5, 2018
Sex
Female
Sole proprietor
Yes

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
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X ISW22064 FL Primary

Addresses

Primary practice location

18300 NW 62ND Ave Ste 200
Hialeah, FL 33015-8207

Mailing address

18300 NW 62ND Ave Ste 200
Hialeah, FL 33015-8207
Phone (786) 304-7731

Other identifiers 1

IdentifierTypeStateIssuer
105098000MedicaidFL

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
ISW22064FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Medical Research LLC Current Accepting new patients
Quality of Life Servicing Corp CurrentSince Aug 1, 2021 Accepting new patients

Locations

18300 NW 62nd Ave
Ste 200
Miami Gardens, FL 33015
Phone (786) 858-7800

13117 NW 42nd Ave
Opa Locka, FL 33054
Phone (786) 304-7731

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DEBAED

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1013419183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18300 NW 62ND AVE STE 200",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330158207",
            "telephone_number": "786-304-7731",
            "fax_number": "786-353-2349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 NW 62ND AVE STE 200",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330158207",
            "telephone_number": "786-304-7731",
            "fax_number": "786-353-2349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ BERMUDEZ",
        "first_name": "ARIADNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-05",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW22064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105098000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.