Individual provider Active NPI

Ana Mary Gonzalez Peralo

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1174316640
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11039787 Issued in FL
Practice address
20641 SW 121St CT
Miami, FL 33177-5370
Phone
(786) 792-4224
NPI assigned
May 27, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 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 PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 11039787 FL Primary

Addresses

Primary practice location

20641 SW 121St CT
Miami, FL 33177-5370

Mailing address

20641 SW 121St CT
Miami, FL 33177-5370
Phone (786) 792-4224

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
I20251230002444 FL Practitioner - Nurse Practitioner 1153817036 Reassigns benefits to 1 organization

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
Intensive Care Experts Health Network, LLCGroup PAC ID 6608195599, 99 clinicians

Practice addresses (Care Compare)

4405 Lakewood Rd
Lake Worth, FL 33461-3414
Phone (561) 969-1400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11039787FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Intensive Care Experts Health Network LLC Single Specialty CurrentSince Dec 1, 2025 Accepting new patients
Intensive Care Experts Health Network LLC Single Specialty CurrentSince Dec 1, 2025 Accepting new patients

Locations

701 N Federal Hwy
Ste 601
Hallandale Beach, FL 33009
Phone (954) 573-2195

1859 Van Buren St
Hollywood, FL 33020
Phone (954) 920-0900

4405 Lakewood Rd
Lake Worth Beach, FL 33461
Phone (561) 630-9321

1626 Davis Rd
West Palm Beach, FL 33406
Phone (561) 265-3525

Organizations & group practices 2

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": "1748304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1174316640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20641 SW 121ST CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331775370",
            "telephone_number": "786-792-4224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20641 SW 121ST CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331775370",
            "telephone_number": "786-792-4224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ PERALO",
        "first_name": "ANA",
        "middle_name": "MARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-27",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11039787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.