Individual provider Active NPI

Gerardo De la Luz Aguilera, APRN

  • Family Nurse Practitioner
  • Davie, FL
National Provider Identifier
1447628508
Registry record updated Sep 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11034711 Issued in FL
Practice address
8716 Berkley Dr
Davie, FL 33324-4545
Phone
(954) 702-3977
NPI assigned
Sep 7, 2015
Last updated
Sep 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11034711 FL Primary
Surgical Assistant 246ZC0007X 13-404 CO

Addresses

Primary practice location

8716 Berkley Dr
Davie, FL 33324-4545

Mailing address

8716 Berkley Dr
Davie, FL 33324-4545
Phone (954) 702-3977

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

State licenses

LicenseStateTypeSpecialty
13-404COMDSurgical Assistant
11034711FLMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: gerardo.delaluzaguilera.p1@direct.vivamasmedical.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1441584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725235200000",
    "number": "1447628508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8716 BERKLEY DR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333244545",
            "telephone_number": "954-702-3977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8716 BERKLEY DR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333244545",
            "telephone_number": "954-702-3977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUILERA",
        "first_name": "GERARDO",
        "middle_name": "DE LA LUZ",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-07",
        "last_updated": "2024-09-02",
        "certification_date": "2024-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11034711",
            "primary": true
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "CO",
            "license": "13-404",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2024; 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.