Individual provider Active NPI

Carolina Vega Gomez, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1023657418
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11004153 Issued in FL
Practice address
120 Beacom Blvd
Miami, FL 33135-1534
Phone
(786) 334-6041
NPI assigned
Jan 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11004153 FL Primary

Addresses

Primary practice location

120 Beacom Blvd
Miami, FL 33135-1534

Mailing address

9003 SW 214TH LN
Cutler Bay, FL 33189-3785
Phone (305) 399-3733

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
11004153FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Delight Medical Clinic CurrentSince Jan 5, 2020 Accepting new patients
Miami Care Medical Center Inc. PastSince Jan 5, 2020 Accepting new patients

Locations

120 Beacom Blvd
Miami, FL 33135
Phone (305) 960-7608

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": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1023657418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9003 SW 214TH LN",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331893785",
            "telephone_number": "305-399-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 BEACOM BLVD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331351534",
            "telephone_number": "786-334-6041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA GOMEZ",
        "first_name": "CAROLINA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-02",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11004153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; 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.