Individual provider Active NPI

Alicia Gonzalez, NP-C

  • Family Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1073059564
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9255886 Issued in FL
Practice address
911 N Central Ave
Kissimmee, FL 34741-5029
Phone
(866) 870-0148
Fax
(407) 386-3428
NPI assigned
Jan 9, 2017
Last updated
Jun 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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 ARNP9255886 FL Primary

Addresses

Primary practice location

911 N Central Ave
Kissimmee, FL 34741-5029

Mailing address

18930 SW 311TH St
Homestead, FL 33030-3845
Phone (786) 547-1280

Other practice location 1

18930 sw 311 st
homestead, FL 33030
Phone (786) 547-1280

Other identifiers 1

IdentifierTypeStateIssuer
020364100MedicaidFL

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP9255886FLMDFamily Nurse Practitioner

Organizations & group practices 1

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": "1483920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1073059564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18930 SW 311TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330303845",
            "telephone_number": "786-547-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 N CENTRAL AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415029",
            "telephone_number": "866-870-0148",
            "fax_number": "407-386-3428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18930 sw 311 st",
            "address_purpose": "LOCATION",
            "city": "homestead",
            "state": "FL",
            "postal_code": "33030",
            "country_code": "US",
            "telephone_number": "786-547-1280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "ALICIA",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-09",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9255886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020364100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.