Individual provider Active NPI

Mariangely Gomez-Melendez, APRN

  • Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1366199432
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11018274 Issued in FL
Practice address
2605 W Swann Ave Ste 600
Tampa, FL 33609-4044
Phone
(813) 876-7073
Fax
(813) 877-1277
NPI assigned
Mar 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11018274 FL Primary

Addresses

Primary practice location

2605 W Swann Ave Ste 600
Tampa, FL 33609-4044

Mailing address

2605 W Swann Ave Ste 600
Tampa, FL 33609-4044
Phone (813) 876-7073

Other practice location 1

1111 Oakfield Dr Ste 111
Brandon, FL 33511-4948
Phone (813) 876-7073

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
I20230322003083 FL Practitioner - Nurse Practitioner 0244604874 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wiregrass Direct Primary Care PLLC CurrentSince Feb 7, 2023 Accepting new patients
Thomas M. Taylor, MD PA Past Accepting new patients
Karon R Locicero MD PA PastSince Aug 30, 2014 Accepting new patients
Florida Medical Clinic, LLC PastSince Feb 7, 2023 Accepting new patients

Locations

2236 Green Hedges Way
Wesley Chapel, FL 33544
Phone (813) 358-3578

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23694/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1646697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1366199432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 W SWANN AVE STE 600",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094044",
            "telephone_number": "813-876-7073",
            "fax_number": "813-877-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 W SWANN AVE STE 600",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094044",
            "telephone_number": "813-876-7073",
            "fax_number": "813-877-1277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 Oakfield Dr Ste 111",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335114948",
            "country_code": "US",
            "telephone_number": "813-876-7073",
            "fax_number": "813-877-1277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMEZ-MELENDEZ",
        "first_name": "MARIANGELY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-08",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11018274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.