Individual provider Active NPI

Taisha W Gonzalez, FNP

  • Nurse Practitioner
  • Apollo Beach, FL
National Provider Identifier
1023638483
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9257619 Issued in FL
Practice address
415 Apollo Beach Blvd
Apollo Beach, FL 33572-2281
Phone
(813) 645-8494
Fax
(813) 645-0912
NPI assigned
Apr 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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 9257619 FL Primary

Addresses

Primary practice location

415 Apollo Beach Blvd
Apollo Beach, FL 33572-2281

Mailing address

415 Apollo Beach Blvd
Apollo Beach, FL 33572-2281
Phone (813) 645-8494

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
I20220829003610 FL Practitioner - Nurse Practitioner 4880080902 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

415 Apollo Beach Blvd
Apollo Beach, FL 33572-2281
Phone (813) 645-8494

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9257619FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
GMS Florida West Coast Inc CurrentSince Aug 11, 2024 Accepting new patients
Wellmed Medical Management of Florida Inc CurrentSince Aug 11, 2024 Accepting new patients
Optumcare Florida LLC CurrentSince Jan 30, 2023 Accepting new patients
Optumcare Florida, LLC CurrentSince Jan 30, 2023 Accepting new patients

Locations

415 Apollo Beach Blvd
Apollo Beach, FL 33572
Phone (813) 645-8494

1989 W Lumsden Rd
Brandon, FL 33511
Phone (813) 653-3111

2940 S US Highway 1
Ste C11
Fort Pierce, FL 34982
Phone (407) 423-5178

1345 West Bay Dr
Ste 202
Largo, FL 33770
Phone (727) 559-0895

1120 10th St E
Palmetto, FL 34221
Phone (941) 847-7903

2155 SE Federal Hwy
Stuart, FL 34994
Phone (772) 223-9630

5130 Sunforest Dr
Ste 300
Tampa, FL 33634
Phone (813) 302-5835

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: taisha.gonzalez@wellmed.eclinicaldirectplus.com
  • Direct secure messaging: taisha.gonzalez@applemedical.directbygreenway.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1587772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1023638483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 APOLLO BEACH BLVD",
            "city": "APOLLO BEACH",
            "state": "FL",
            "postal_code": "335722281",
            "telephone_number": "813-645-8494",
            "fax_number": "813-645-0912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 APOLLO BEACH BLVD",
            "city": "APOLLO BEACH",
            "state": "FL",
            "postal_code": "335722281",
            "telephone_number": "813-645-8494",
            "fax_number": "813-645-0912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "TAISHA",
        "middle_name": "W",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-25",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "9257619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apollo Beach, FL

Sources for this page

Verify at the official NPI Registry.