Active NPI
Maria Gonzalez, OD,PA
- Optometrist
- Coral Gables, FL
National Provider Identifier
1356323810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OP2796
- Practice address
- 2264 Coral Way
Coral Gables, FL 33145-3509 - Phone
- (305) 854-0736
- Fax
- (305) 490-0754
- NPI assigned
- Nov 18, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OP2796 | FL | Primary |
Addresses
Primary practice location
2264 Coral Way
Coral Gables, FL 33145-3509
Mailing address
2264 Coral Way
Coral Gables, FL 33145-3509
Phone (305) 854-0736
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 620085100 | Medicaid | FL |
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031106000719 | FL | Practitioner - Optometry | 6608789573 | Practice locations: Miami, FL |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of Houston - College of Optometry, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2264 Coral Way
Coral Gables, FL 33145-3509
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OP2796 | FL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343952000000",
"number": "1356323810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2264 CORAL WAY",
"city": "CORAL GABLES",
"state": "FL",
"postal_code": "331453509",
"telephone_number": "305-854-0736",
"fax_number": "305-490-0754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2264 CORAL WAY",
"city": "CORAL GABLES",
"state": "FL",
"postal_code": "331453509",
"telephone_number": "305-854-0736",
"fax_number": "305-490-0754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "MARIA",
"name_prefix": "Dr.",
"credential": "OD,PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-11-18",
"last_updated": "2012-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OP2796",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "620085100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coral Gables, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2012; 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.