Individual provider Active NPI

Manuel Valladares Gonzalez, APRN

  • Family Nurse Practitioner
  • Miami Lakes, FL
National Provider Identifier
1164803078
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11039712 Issued in FL
Practice address
15700 NW 67TH Ave Ste 102
Miami Lakes, FL 33014-2112
Phone
(786) 434-5987
Fax
(786) 434-5988
NPI assigned
Jun 16, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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 APRN11039712 FL Primary

Addresses

Primary practice location

15700 NW 67TH Ave Ste 102
Miami Lakes, FL 33014-2112

Mailing address

PO Box 4189
Deerfield Beach, FL 33442-4189
Phone (954) 363-9582

Other identifiers 1

IdentifierTypeStateIssuer
127290200MedicaidFL

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
I20250612003266 FL Practitioner - Nurse Practitioner 5991216434 Reassigns benefits to 2 organizations
Practice locations: Miami, FL

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Xpress Urgent Care LLCGroup PAC ID 0042454944, 31 clinicians

Practice addresses (Care Compare)

15700 NW 67TH Ave
Suite 102
Miami Lakes, FL 33014-2112
Phone (954) 363-9582

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11039712FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Consultants of Florida, LLC Current Accepting new patients
Xpress Urgent Care, LLC. CurrentSince Jun 24, 2025 Accepting new patients
Xpress Urgent Care, LLC. PastSince Dec 21, 2021 Accepting new patients

Locations

18430 S Dixie Hwy
Ste 102
Cutler Bay, FL 33157
Phone (305) 918-1160

15700 NW 67th Ave
Ste 102
Miami Lakes, FL 33014
Phone (786) 434-5987

672 SW Prima Vista Blvd
#10
Port St Lucie, FL 34983
Phone (772) 905-2555

Organizations & group practices 4

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": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1164803078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4189",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334424189",
            "telephone_number": "954-363-9582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15700 NW 67TH AVE STE 102",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142112",
            "telephone_number": "786-434-5987",
            "fax_number": "786-434-5988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLADARES GONZALEZ",
        "first_name": "MANUEL",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-16",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11039712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127290200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

Verify at the official NPI Registry.