Individual provider Active NPI

Mariena Gonzalez, AGACNP APRN

  • Adult Health Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1396542783
Registry record updated Nov 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN11037770 Issued in FL
Practice address
701 6TH St S
St Petersburg, FL 33701-4814
Phone
(727) 893-6220
Fax
(727) 893-6865
NPI assigned
Feb 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN11037770 FL
Adult Health Nurse Practitioner 363LA2200X APRN11037770 FL Primary

Addresses

Primary practice location

701 6TH St S
St Petersburg, FL 33701-4814

Mailing address

701 6TH St S
St Petersburg, FL 33701-4814
Phone (727) 893-6220

Other identifiers 1

IdentifierTypeStateIssuer
128475700MedicaidFL

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
I20250924003909 FL Practitioner - Nurse Practitioner 8123523784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohi West Medical Group LLCGroup PAC ID 2668882507, 200 clinicians

Practice addresses (Care Compare)

603 7TH St S
St Petersburg, FL 33701-4719

701 6TH St S
St Petersburg, FL 33701-4814
Phone (727) 823-1234

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ohi West Medical Group, LLC Current Accepting new patients
Ohi West Medical Group, LLC CurrentSince Oct 1, 2025 Accepting new patients
Ohi West Medical Group, LLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

701 6th St S
St Petersburg, FL 33701
Phone (727) 450-1144

Organizations & group practices 3

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": "1740441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763164800000",
    "number": "1396542783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 6TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014814",
            "telephone_number": "727-893-6220",
            "fax_number": "727-893-6865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 6TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014814",
            "telephone_number": "727-893-6220",
            "fax_number": "727-893-6865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MARIENA",
        "credential": "AGACNP APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-25",
        "last_updated": "2025-11-15",
        "certification_date": "2025-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11037770",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11037770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128475700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.