Jose Luis Gonzalez-Roman, APRN,FNP-C,PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN11012338 Issued in FL

Practice address

14888 Summer Branch Dr
Lithia, FL 33547-5130

Phone

(813) 502-9354

NPI assigned

Aug 11, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/DCIGDD/Endpoint/DCIGDD

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.

• Balance Healing Solutions Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Lithia, FL
  • NPI 1407666134

  Family

  NPD Authorized official
• Bonita Springs Retirement Village, Inc.

  dba The Terraces at Bonita Springs

  • Skilled Nursing Facility
  • Bonita Springs, FL
  • NPI 1700126802
  NPD
• Dna Comprehensive Therapy Services, LLC

  dba Elite DNA Therapy Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Myers, FL
  • NPI 1316363757
  NPD
• Jorge Amador MD LLC

  • Family Medicine Physician
  • Newnan, GA
  • NPI 1669895959
  NPD (past)
• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Savannah, GA
  • NPI 1356907273
  NPD (past)

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

{
    "created_epoch": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1063187128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14888 SUMMER BRANCH DR",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335475130",
            "telephone_number": "813-502-9354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14888 SUMMER BRANCH DR",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335475130",
            "telephone_number": "813-502-9354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ-ROMAN",
        "first_name": "JOSE",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "APRN,FNP-C,PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-11",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11012338",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11012338",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "GAA-NP-000179",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Glass
• Goddard One Medical PLLC
• James A Godin, PT
• Scott Eric Goldsmith, M.D.
• Stuart Alan Goldsmith, M.D.
• Roberto Gonzalez, ATC
• Michael Derek Gould
• Greater Good Enterprises, LLC
• Lorie-Anne Grey
• Brandi Griffin

• Psychiatric/Mental Health Nurse Practitioner in Lithia, FL
• Providers in Lithia, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.