Gonzalo Portal Lemock, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11030115 Issued in FL

Practice address

18300 NW 62ND Ave Ste 210
Miami Gardens, FL 33015-8207

Phone

(786) 677-9922

Fax

(844) 895-3066

NPI assigned

Dec 13, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Passqual IncGroup PAC ID 2264848290, 4 clinicians

Practice addresses (Care Compare)

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.

• Passqual, Inc.

  • Family Medicine Physician
  • Miami Gardens, FL
  • NPI 1427677319
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1702425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1306614920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18300 NW 62ND AVE STE 210",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330158207",
            "telephone_number": "786-677-9922",
            "fax_number": "844-895-3066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 NW 62ND AVE STE 210",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330158207",
            "telephone_number": "786-677-9922",
            "fax_number": "844-895-3066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTAL LEMOCK",
        "first_name": "GONZALO",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-13",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11030115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Diana Polite-Eaford, LCSW
• Polka Line Supplies Inc
• Danielly Pombo Gavilan
• Daibelys Ponce
• Amanda Sofia Pons Valdes
• Julio Portal
• Yudeny D Portal, RBT
• Yaimaris Portela
• Jacqueline Angeles Portobanco
• Maria Portobanco, OTR/L

• Family Nurse Practitioner in Miami Gardens, FL
• Providers in Miami Gardens, 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 Jan 10, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.