Active NPI
Florangel Gomez Edralin, M.D.
- Pediatrics Physician
- Palatka, FL
National Provider Identifier
1093732919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME65289
- Practice address
- 6910 Old Wolf Bay Rd
Palatka, FL 32177-6800 - Phone
- (386) 328-7337
- Fax
- (386) 325-3742
- NPI assigned
- Jul 16, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME65289 | FL | Primary |
Addresses
Primary practice location
6910 Old Wolf Bay Rd
Palatka, FL 32177-6800
Mailing address
6910 Old Wolf Bay Rd
Palatka, FL 32177-6800
Phone (386) 328-7337
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME65289 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Primary Care Inc | Pediatrics | Past | Accepting new patients |
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": "1153008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593561600000",
"number": "1093732919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6910 OLD WOLF BAY RD",
"city": "PALATKA",
"state": "FL",
"postal_code": "321776800",
"telephone_number": "386-328-7337",
"fax_number": "386-325-3742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6910 OLD WOLF BAY RD",
"city": "PALATKA",
"state": "FL",
"postal_code": "321776800",
"telephone_number": "386-328-7337",
"fax_number": "386-325-3742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDRALIN",
"first_name": "FLORANGEL",
"middle_name": "GOMEZ",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-16",
"last_updated": "2020-07-01",
"certification_date": "2020-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME65289",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palatka, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.