Individual provider Active NPI

Delio Guillermo Gomez

  • Family Nurse Practitioner
  • Hialeah, FL
National Provider Identifier
1417575275
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11007949 Issued in FL
Practice address
2750 W 68TH St
Hialeah, FL 33016-5446
Phone
(305) 558-0765
NPI assigned
Jul 8, 2020
Last updated
Mar 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11007949 FL Primary

Addresses

Primary practice location

2750 W 68TH St
Hialeah, FL 33016-5446

Mailing address

2750 W 68TH St
# 127-128
Hialeah, FL 33016-5446
Phone (305) 558-0765

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
I20210311000966 FL Practitioner - Nurse Practitioner 5294141586 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11007949FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Las Mercedes, LLC CurrentSince Mar 9, 2021 Accepting new patients
Clinica Las Mercedes, LLC CurrentSince Mar 9, 2021 Accepting new patients
Kidney Specialty Center Inc. PastSince Jul 12, 2020 Accepting new patients

Locations

149 W 21st St
Hialeah, FL 33010
Phone (786) 315-1539

2750 W 68th St
#127128
Hialeah, FL 33016
Phone (305) 558-0765

1479 NW 27th Ave
Miami, FL 33125
Phone (305) 633-3776

6355 NW 36th St
Ste 1100
Virginia Gardens, FL 33166

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, 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": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1417575275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 W 68TH ST",
            "address_2": "# 127-128",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330165446",
            "telephone_number": "305-558-0765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 W 68TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330165446",
            "telephone_number": "305-558-0765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "DELIO",
        "middle_name": "GUILLERMO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-08",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11007949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.