Individual provider Active NPI

Annia Maritza Gonzalez Arencibia, MD

  • General Practice Physician
  • Auburndale, FL
National Provider Identifier
1396497616
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN1505 Issued in FL
Practice address
394 Havendale Blvd
Auburndale, FL 33823-4527
Phone
(863) 327-0131
Fax
(863) 777-2307
NPI assigned
Jan 19, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X ACN1505 FL Primary

Addresses

Primary practice location

394 Havendale Blvd
Auburndale, FL 33823-4527

Mailing address

6100 Blue Lagoon Dr Ste 365
Miami, FL 33126-7010
Phone (786) 322-7333

Other practice location 1

5615 S Florida Ave Ste 111
Lakeland, FL 33813-2714
Phone (863) 327-0132

Other identifiers 1

IdentifierTypeStateIssuer
117041700MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230223001569 FL Practitioner - General Practice 9830562735 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
ACN1505FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Access Medical Group of Lakeland, LLC Single Specialty CurrentSince Jan 5, 2025 Accepting new patients
Access Medical Group of Tampa, LLC. Single Specialty PastSince Nov 5, 2018 Accepting new patients

Locations

5615 S Florida Ave
Ste 111
Lakeland, FL 33813
Phone (863) 327-0132

6100 Blue Lagoon Dr
Ste 365
Miami, FL 33126
Phone (786) 322-7333

Organizations & group practices 2

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": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1396497616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 BLUE LAGOON DR STE 365",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331267010",
            "telephone_number": "786-322-7333",
            "fax_number": "786-347-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "394 HAVENDALE BLVD",
            "city": "AUBURNDALE",
            "state": "FL",
            "postal_code": "338234527",
            "telephone_number": "863-327-0131",
            "fax_number": "863-777-2307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5615 S Florida Ave Ste 111",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338132714",
            "country_code": "US",
            "telephone_number": "863-327-0132",
            "fax_number": "863-777-2320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ ARENCIBIA",
        "first_name": "ANNIA",
        "middle_name": "MARITZA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-19",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117041700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburndale, FL

Sources for this page

Verify at the official NPI Registry.