Individual provider Active NPI

Evelin Gonzalez Fernandez, APRN/FNP

  • Family Nurse Practitioner
  • Deltona, FL
National Provider Identifier
1255959615
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11008039 Issued in FL
Practice address
2187 Howland Blvd
Deltona, FL 32738-3441
Phone
(386) 789-0813
NPI assigned
Jul 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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 APRN11008039 FL Primary

Addresses

Primary practice location

2187 Howland Blvd
Deltona, FL 32738-3441

Mailing address

2187 Howland Blvd
Deltona, FL 32738-3441
Phone (386) 789-0813

Other practice location 1

306 Lincoln Rd
Miami Beach, FL 33139-3103
Phone (305) 531-5583

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
I20210202001157 FL Practitioner - Nurse Practitioner 2365856481 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic LLC Family CurrentSince Oct 1, 2020 Accepting new patients

Locations

2187 Howland Blvd
Deltona, FL 32738
Phone (386) 789-0813

121 W Macclenny Ave
Macclenny, FL 32063
Phone (904) 259-6380

312 Lincoln Rd
Miami Beach, FL 33139
Phone (305) 531-7311

12401 Miramar Pkwy
Miramar, FL 33027
Phone (954) 538-8473

8765 S Dixie Hwy
Pinecrest, FL 33156
Phone (305) 740-6840

7599 W Sand Lake Rd
Sand Lake, FL 32819
Phone (407) 352-0943

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1255959615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2187 HOWLAND BLVD",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327383441",
            "telephone_number": "386-789-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2187 HOWLAND BLVD",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327383441",
            "telephone_number": "386-789-0813"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "306 Lincoln Rd",
            "address_purpose": "LOCATION",
            "city": "Miami Beach",
            "state": "FL",
            "postal_code": "331393103",
            "country_code": "US",
            "telephone_number": "305-531-5583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ FERNANDEZ",
        "first_name": "EVELIN",
        "credential": "APRN/FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11008039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deltona, FL

Sources for this page

Verify at the official NPI Registry.