Active NPI
Glorimar Llavona Gonzalez, D.M.D.
- Dentist
- Pembroke Pines, FL
National Provider Identifier
1205079878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN17469
- Practice address
- 18503 Pines Blvd Ste 305
Pembroke Pines, FL 33029-1406 - Phone
- (954) 349-4993
- NPI assigned
- Apr 13, 2009
- Last updated
- Mar 14, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN17469 | FL | Primary |
Addresses
Primary practice location
18503 Pines Blvd Ste 305
Pembroke Pines, FL 33029-1406
Mailing address
2575 Glades Cir Ste 3
Weston, FL 33327-2254
Phone (305) 542-5241
Other practice location 1
2575 Glades Cir Ste 3
Weston, FL 33327-2254
Phone (954) 349-4993
Other practice location 2
3601 NW 107th Ave Fl 3
Doral, FL 33178-4377
Phone (786) 624-3368
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN17469 | FL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oliverllavona LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710374400000",
"number": "1205079878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2575 GLADES CIR STE 3",
"city": "WESTON",
"state": "FL",
"postal_code": "333272254",
"telephone_number": "305-542-5241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18503 PINES BLVD STE 305",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330291406",
"telephone_number": "954-349-4993"
}
],
"practiceLocations": [
{
"address_1": "2575 Glades Cir Ste 3",
"address_purpose": "LOCATION",
"city": "Weston",
"state": "FL",
"postal_code": "333272254",
"country_code": "US",
"telephone_number": "954-349-4993",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3601 NW 107th Ave Fl 3",
"address_purpose": "LOCATION",
"city": "Doral",
"state": "FL",
"postal_code": "331784377",
"country_code": "US",
"telephone_number": "786-624-3368",
"fax_number": "305-418-7777",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LLAVONA GONZALEZ",
"first_name": "GLORIMAR",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-04-13",
"last_updated": "2024-03-14",
"certification_date": "2024-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN17469",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pembroke Pines, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.