Individual provider Active NPI

Lisbet Yamel Gongora

  • Nurse Practitioner
  • Bradenton, FL
National Provider Identifier
1386565604
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11049360 Issued in FL
Practice address
2809 20TH Avenue Dr W
Bradenton, FL 34205-3825
Phone
(702) 771-6702
NPI assigned
Jul 22, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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 11049360 FL Primary

Addresses

Primary practice location

2809 20TH Avenue Dr W
Bradenton, FL 34205-3825

Mailing address

2809 20TH Avenue Dr W
Bradenton, FL 34205-3825
Phone (702) 771-6702

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

NPI Registry JSON

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

{
    "created_epoch": "1784678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1386565604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 20TH AVENUE DR W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342053825",
            "telephone_number": "702-771-6702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 20TH AVENUE DR W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342053825",
            "telephone_number": "702-771-6702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONGORA",
        "first_name": "LISBET",
        "middle_name": "YAMEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-22",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11049360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; 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.