Individual provider Active NPI

Middeliza Gomez Lorenzo

  • Case Manager/Care Coordinator
  • Doral, FL
National Provider Identifier
1194495671
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
CBHCM103793 Issued in FL
Practice address
8180 NW 36TH St Ste 209
Doral, FL 33166-6653
Phone
(786) 334-6946
Fax
(786) 313-3079
NPI assigned
Sep 16, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X CBHCM103793 FL Primary

Addresses

Primary practice location

8180 NW 36TH St Ste 209
Doral, FL 33166-6653

Mailing address

8180 NW 36TH St Ste 209
Doral, FL 33166-6653
Phone (786) 334-6946

Other identifiers 1

IdentifierTypeStateIssuer
CBHCM103793OtherFLFLORIDA CERTIFICATION BOARD

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CBHCM103793FLMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
New Hope Case Management Services Inc CurrentSince Oct 5, 2021 Accepting new patients
Gomez Social Services Inc Current Accepting new patients
New Hope Case Management Services Inc CurrentSince Mar 19, 2023 Accepting new patients

Locations

8180 NW 36th St
Ste 209
Doral, FL 33166
Phone (786) 334-6946

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": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1194495671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8180 NW 36TH ST STE 209",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666653",
            "telephone_number": "786-334-6946",
            "fax_number": "786-313-3079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8180 NW 36TH ST STE 209",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666653",
            "telephone_number": "786-334-6946",
            "fax_number": "786-313-3079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ LORENZO",
        "first_name": "MIDDELIZA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-16",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": "CBHCM103793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA CERTIFICATION BOARD",
            "identifier": "CBHCM103793",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; 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.