Individual provider Active NPI

Gustavo A. Manrique Pico, APRN

  • Family Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1205132982
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11031976 Issued in FL
Practice address
2400 N Orange Blossom TRL Ste 210
Kissimmee, FL 34744-2308
Phone
(407) 933-2500
NPI assigned
Jan 28, 2011
Last updated
Sep 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 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 Practitioner 363LF0000X APRN11031976 FL Primary

Addresses

Primary practice location

2400 N Orange Blossom TRL Ste 210
Kissimmee, FL 34744-2308

Mailing address

2400 N Orange Blossom TRL Ste 210
Kissimmee, FL 34744-2308
Phone (407) 933-2500

Other practice location 1

160 W Tyler St Unit 355
Tampa, FL 33602-3926
Phone (713) 256-2182

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
I20240920000716 FL Practitioner - Nurse Practitioner 9234670068 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2400 N Orange Blossom TRL
Kissimmee, FL 34744-2308

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11031976FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Sep 8, 2025 Accepting new patients
Millennium Physician Group LLC CurrentSince Sep 1, 2024 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Sep 8, 2025 Accepting new patients
Millennium Physician Group LLC CurrentSince Sep 1, 2024 Accepting new patients

Locations

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

2400 N Orange Blossom Trl
Ste 210
Kissimmee, FL 34744
Phone (407) 933-2500

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

3440 Tamiami Trl
Ste 2A
Port Charlotte, FL 33952
Phone (941) 624-3600

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

3440 Tamiami Trl
Unit 2
Pt Charlotte, FL 33952
Phone (941) 624-3600

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1296172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1205132982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 N ORANGE BLOSSOM TRL STE 210",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347442308",
            "telephone_number": "407-933-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N ORANGE BLOSSOM TRL STE 210",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347442308",
            "telephone_number": "407-933-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 W Tyler St Unit 355",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336023926",
            "country_code": "US",
            "telephone_number": "713-256-2182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANRIQUE PICO",
        "first_name": "GUSTAVO",
        "middle_name": "A.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-28",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11031976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.