Individual provider Active NPI

Briseida Gordillo, ARNP

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1174709141
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9205771 Issued in FL
Practice address
11430 SW 88 Street, Suite 108
Miami, FL 33176
Phone
(305) 905-4758
Fax
(305) 677-3578
NPI assigned
Jan 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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 APRN9205771 FL Primary

Addresses

Primary practice location

11430 SW 88 Street, Suite 108
Miami, FL 33176

Mailing address

11430 N Kendall Dr Ste 108
Miami, FL 33176-1041
Phone (305) 905-4758

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

State licenses

LicenseStateTypeSpecialty
APRN9205771FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Intyma LLC CurrentSince Jun 26, 2022 Accepting new patients

Locations

11430 SW 88th St
Ste 108
Miami, FL 33176
Phone (305) 677-3578

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": "1200873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1174709141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11430 N KENDALL DR STE 108",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761041",
            "telephone_number": "305-905-4758",
            "fax_number": "305-677-3578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11430 SW 88 STREET, SUITE 108",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33176",
            "telephone_number": "305-905-4758",
            "fax_number": "305-677-3578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDILLO",
        "first_name": "BRISEIDA",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-21",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9205771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.