Leah Angela Gonzales, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11020504 Issued in FL

Practice address

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708

Phone

(850) 863-7607

NPI assigned

Jun 28, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Leah Angela Phillips Ortenzo Former name

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

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.

• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment NPD
• FL-I Medical Services, LLC

  • Nurse Practitioner
  • Fort Pierce, FL
  • NPI 1750655106
  Medicare reassignment NPD
• FL-I Medical Services LLC

  • Emergency Medicine Physician
  • Fort Walton Beach, FL
  • NPI 1144679168
  NPD
• FL-I Medical Services LLC

  • Physician Assistant
  • Haines City, FL
  • NPI 1285356790
  NPD

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

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1225760259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 SOLAR ST",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325691535",
            "telephone_number": "770-584-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476708",
            "telephone_number": "850-863-7607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "LEAH",
        "middle_name": "ANGELA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-28",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11020504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEAH",
            "last_name": "ORTENZO",
            "middle_name": "ANGELA PHILLIPS",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Andrew Allen Godwin, D.C.
• Megan N Godwin
• Jennifer Rebecca Goette, OD
• Jolyn Marie Gontis, CRNA
• Jerille Gay Hong Gonzales, MD
• Catalina Teresa Gonzalez
• Yahaida Gonzalez
• Nekia Re'Shon Gooden, LCSW
• Ashley Brooke Goodson, MS, CF-SLP
• Jason Gosnell, L.M.H.C.

• Family Nurse Practitioner in Fort Walton Beach, FL
• Providers in Fort Walton Beach, 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 Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.