Individual provider Active NPI

Gabriel L Gonzales, DPT

  • Physical Therapist
  • Orlando, FL
National Provider Identifier
1093471021
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT37859 Issued in FL
Practice address
14115 Town Loop Blvd Ste 200
Orlando, FL 32837-4839
Phone
(407) 601-3922
NPI assigned
Nov 15, 2021
Last updated
Jun 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT37859 FL Primary

Addresses

Primary practice location

14115 Town Loop Blvd Ste 200
Orlando, FL 32837-4839

Mailing address

1755 Split Fork Dr
Oldsmar, FL 34677-2768
Phone (813) 300-6843

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230111001961 FL Practitioner - Physical Therapist in Private Practice 3375913171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy Specialists of Hunters Creek LLCGroup PAC ID 1355576745, 6 clinicians

Practice addresses (Care Compare)

14115 Town Loop Blvd
Suite 200
Orlando, FL 32837-4839
Phone (407) 601-3922

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT37859FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Specialists of Hunters Creek, LLC Physical Therapist CurrentSince Dec 1, 2022 Accepting new patients
Cora Health Services, Inc PastSince Nov 1, 2021 Accepting new patients
Cora Health Services Inc PastSince Nov 1, 2021 Accepting new patients

Locations

14115 Town Loop Blvd
Ste 200
Orlando, FL 32837
Phone (407) 601-3922

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 3

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": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1093471021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 SPLIT FORK DR",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346772768",
            "telephone_number": "813-300-6843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14115 TOWN LOOP BLVD STE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328374839",
            "telephone_number": "407-601-3922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "GABRIEL",
        "middle_name": "L",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-15",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT37859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.