Individual provider Active NPI

Durvin Gloria Bonome Hermosilla, APRN

  • Primary Care Nurse Practitioner
  • Miami, FL
National Provider Identifier
1467066407
Registry record updated Feb 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN11008943 Issued in FL
Practice address
1013 NW 29TH Ave
Miami, FL 33125-2924
Phone
(786) 609-1183
NPI assigned
Sep 8, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X APRN11008943 FL Primary

Addresses

Primary practice location

1013 NW 29TH Ave
Miami, FL 33125-2924

Mailing address

1013 NW 29TH Ave
Miami, FL 33125-2924
Phone (786) 609-1183

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
I20240517003252 FL Practitioner - Nurse Practitioner 9436509221 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Felix Varela Medical Clinic, Inc CurrentSince May 7, 2024 Accepting new patients

Locations

175 W 49th St
Hialeah, FL 33012
Phone (786) 621-9777

Organizations & group practices 1

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": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675555200000",
    "number": "1467066407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 NW 29TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331252924",
            "telephone_number": "786-609-1183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 NW 29TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331252924",
            "telephone_number": "786-609-1183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONOME HERMOSILLA",
        "first_name": "DURVIN",
        "middle_name": "GLORIA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-08",
        "last_updated": "2023-02-05",
        "certification_date": "2023-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN11008943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.