Individual provider Active NPI

Wilfredo Morales Gonzalez

  • Case Manager/Care Coordinator
  • Miami Shores, FL
National Provider Identifier
1376067108
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
9999 NE 2ND Ave Ste 203
Miami Shores, FL 33138-2345
Phone
(786) 580-5131
Fax
(786) 580-5149
NPI assigned
Aug 2, 2017
Last updated
Jun 15, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X NU Primary
Behavior Technician 106S00000X NU

Addresses

Primary practice location

9999 NE 2ND Ave Ste 203
Miami Shores, FL 33138-2345

Mailing address

9999 NE 2ND Ave Ste 203
Miami Shores, FL 33138-2345
Phone (786) 580-5131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Care Dimensions Inc CurrentSince Aug 28, 2021 Accepting new patients
Care Dimensions Inc CurrentSince Oct 1, 2020 Accepting new patients
Heartwell Home Health Care Corp. Past Accepting new patients
Heartwell Home Health Care Corp. Behavior Analyst PastSince Sep 23, 2021 Accepting new patients

Locations

9999 NE 2nd Ave
Ste 203
Miami Shores, FL 33138
Phone (305) 591-7898

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1376067108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9999 NE 2ND AVE STE 203",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331382345",
            "telephone_number": "786-580-5131",
            "fax_number": "786-580-5149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9999 NE 2ND AVE STE 203",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331382345",
            "telephone_number": "786-580-5131",
            "fax_number": "786-580-5149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES GONZALEZ",
        "first_name": "WILFREDO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-02",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Shores, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.