Individual provider Active NPI

Gabrielle Fernandez, PA-C

  • Physician Assistant
  • Hialeah, FL
National Provider Identifier
1104799048
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9120900 Issued in FL
Practice address
1698 W 65TH St
Hialeah, FL 33012-6110
Phone
(305) 200-6137
NPI assigned
Sep 26, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9120900 FL Primary

Addresses

Primary practice location

1698 W 65TH St
Hialeah, FL 33012-6110

Mailing address

1698 W 65TH St
Hialeah, FL 33012-6110
Phone (305) 200-6137

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
I20251223004608 FL Practitioner - Physician Assistant 5991290264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1698 W 65TH St
Hialeah, FL 33012-6110

9111 Park Dr
Miami Shores, FL 33138-3159

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9120900FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vilmed Inc CurrentSince Dec 16, 2025 Accepting new patients

Locations

9111 Park Dr
Miami Shores, FL 33138
Phone (305) 756-6110

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1758844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1104799048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1698 W 65TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330126110",
            "telephone_number": "305-200-6137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1698 W 65TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330126110",
            "telephone_number": "305-200-6137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "GABRIELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-26",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9120900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.