Jacqueline Terra-Goncalves

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP9356655 Issued in FL

Practice address

222 S Flamingo Rd
Pembroke Pines, FL 33027-1721

Phone

(954) 442-0029

NPI assigned

Mar 13, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jacqueline Terra Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Pembroke Pines Community Health Center Inc

  • Family Medicine Physician
  • Pembroke Pines, FL
  • NPI 1326774308
  NPD

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

{
    "created_epoch": "1457827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457827200000",
    "number": "1174984520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20905 BOCA RIDGE DR S",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334281509",
            "telephone_number": "781-420-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S FLAMINGO RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271721",
            "telephone_number": "954-442-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRA-GONCALVES",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-13",
        "last_updated": "2016-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9356655",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9356655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "TERRA",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patricia Gonzalez Templeton, D.D.S
• Alfredo E Tendler, DMD, MS
• Tendra Home Health , Inc.
• Tendra Home Health, Inc.
• Lesley Olivia Tenn, D.M.D
• Terry L Boeckel OD Inc
• The Butterfly Affect Therapy Services, Inc
• The Canaan Center LLC
• The Daily Promises, Inc
• The Diabetic Place LLC

• Family Nurse Practitioner in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2016; 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.