Individual provider Active NPI

Andres Gonzalez Garcia

  • Psychiatric/Mental Health Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1255196325
Registry record updated Jan 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11031268 Issued in FL
Practice address
12542 Pines Blvd
Pembroke Pines, FL 33027-1713
Phone
(954) 391-9478
NPI assigned
Feb 19, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 11031268 FL Primary

Addresses

Primary practice location

12542 Pines Blvd
Pembroke Pines, FL 33027-1713

Mailing address

12542 Pines Blvd
Pembroke Pines, FL 33027-1713
Phone (954) 391-9478

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
I20251208000461 FL Practitioner - Nurse Practitioner 5193218105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Serenity Community Mental Health Center LLCGroup PAC ID 4587946793, 14 clinicians

Practice addresses (Care Compare)

3621 SW 107TH Ave
Miami, FL 33165-3636
Phone (786) 534-8366

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11031268FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Community Mental Health Center LLC Psychiatry CurrentSince Oct 30, 2025 Accepting new patients
Serenity Community Mental Health Center LLC Single Specialty CurrentSince Oct 30, 2025 Accepting new patients

Locations

3621 SW 107th Ave
Miami, FL 33165
Phone (305) 221-6862

12542 Pines Blvd
Pembroke Pines, FL 33027
Phone (954) 391-9478

Organizations & group practices 2

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": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769817600000",
    "number": "1255196325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12542 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271713",
            "telephone_number": "954-391-9478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12542 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271713",
            "telephone_number": "954-391-9478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ GARCIA",
        "first_name": "ANDRES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-19",
        "last_updated": "2026-01-31",
        "certification_date": "2026-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11031268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.