Individual provider Active NPI

Tania Gonzalez Diaz, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Miami Gardens, FL
National Provider Identifier
1053083048
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11015458 Issued in FL
Practice address
18463 NW 52ND Psge
Miami Gardens, FL 33055-2398
Phone
(786) 269-1606
NPI assigned
Sep 29, 2021
Last updated
Jul 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11015458 FL Primary

Addresses

Primary practice location

18463 NW 52ND Psge
Miami Gardens, FL 33055-2398

Mailing address

3621 SW 107TH Ave
Miami, FL 33165-3636
Phone (786) 534-8366

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
I20230419000242 FL Practitioner - Nurse Practitioner 1658746904 Reassigns benefits to 6 organizations
Practice locations: Miami Gardens, FL

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Ahn LLCGroup PAC ID 3870954746, 3 clinicians

Practice addresses (Care Compare)

12542 Pines Blvd
Pembroke Pines, FL 33027-1713
Phone (954) 391-9478

3901 NW 79TH Ave
Suite 120
Doral, FL 33166-6554
Phone (786) 310-4480

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11015458FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
True Life Behavioral Network, Inc CurrentSince Dec 22, 2025 Accepting new patients
Serenity Community Mental Health Center LLC Current Accepting new patients
JDS Calm Health Corp Psychiatric/Mental Health CurrentSince Dec 9, 2025 Accepting new patients
Serenity Community Mental Health Center LLC CurrentSince Oct 16, 2024 Accepting new patients
Ahn LLC CurrentSince Apr 15, 2024 Accepting new patients
Serenity Community Mental Health Center LLC Past Accepting new patients

Locations

3901 NW 79th Ave
Ste 120
Doral, FL 33166
Phone (305) 552-7660

13500 N Kendall Dr
Ste 129
Miami, FL 33186
Phone (786) 628-2530

3621 SW 107th Ave
Miami, FL 33165
Phone (305) 221-6862

4155 SW 130th Ave
Ste 114
Miami, FL 33175
Phone (956) 293-5008

9963 SW 142nd Ave
Miami, FL 33186
Phone (786) 360-5558

12542 Pines Blvd
Pembroke Pines, FL 33027
Phone (954) 391-9478

110 Century Blvd
Ste 200
West Palm Beach, FL 33417
Phone (561) 282-2960

Organizations & group practices 8

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": "1632873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1053083048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 SW 107TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331653636",
            "telephone_number": "786-534-8366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18463 NW 52ND PSGE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330552398",
            "telephone_number": "786-269-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ DIAZ",
        "first_name": "TANIA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-29",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11015458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Gardens, FL

Sources for this page

Verify at the official NPI Registry.