Individual provider Active NPI

Yanet Bonet Gongora, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Miami, FL
National Provider Identifier
1124658240
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11003186 Issued in FL
Practice address
3100 SW 62ND Ave
Miami, FL 33155-3009
Phone
(305) 666-6511
NPI assigned
Jan 16, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11003186 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11003186 FL Primary

Addresses

Primary practice location

3100 SW 62ND Ave
Miami, FL 33155-3009

Mailing address

15381 SW 11TH St
Miami, FL 33194-2687
Phone (305) 219-3240

Other practice location 1

15381 SW 11th St
Miami, FL 33194-2687
Phone (305) 219-3240

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
I20230406001839 FL Practitioner - Nurse Practitioner 5496129710

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11003186FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Face to Face Mental Health Services, LLC CurrentSince Jan 31, 2024 Accepting new patients
Yny Behavioral Services LLC CurrentSince May 1, 2023 Accepting new patients
Oceanlight Psychiatry and Wellness, LLC Psychiatric/Mental Health CurrentSince Feb 1, 2022 Accepting new patients

Locations

790 NW 107th Ave
Ste 110
Miami, FL 33172
Phone (305) 964-5426

15924 SW 92nd Ave
Palmetto Bay, FL 33157
Phone (305) 964-5824

15954 SW 92ND Ave
Palmetto Bay, FL 33157
Phone (305) 964-5824

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1579132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1124658240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15381 SW 11TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331942687",
            "telephone_number": "305-219-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SW 62ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331553009",
            "telephone_number": "305-666-6511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15381 SW 11th St",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331942687",
            "country_code": "US",
            "telephone_number": "305-219-3240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONET GONGORA",
        "first_name": "YANET",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-16",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11003186",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11003186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.