Individual provider Active NPI

Daniel J Gonzalez Respeto, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Doral, FL
National Provider Identifier
1477274249
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11021783 Issued in FL
Practice address
11320 NW 43Rd Ter
Doral, FL 33178-4204
Phone
(787) 461-4719
NPI assigned
Sep 8, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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 11021783 FL Primary

Addresses

Primary practice location

11320 NW 43Rd Ter
Doral, FL 33178-4204

Mailing address

11320 NW 43Rd Ter
Doral, FL 33178-4204
Phone (787) 461-4719

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230126000202 FL Practitioner - Nurse Practitioner 4385015551 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11021783FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Lake Ranch Assisted Living LLC Current Accepting new patients
Monogram Health Professional Services of Florida LLC Family CurrentSince Jan 14, 2024 Accepting new patients

Locations

4720 Salisbury Rd
Jacksonville, FL 32256
Phone (866) 932-2777

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": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1477274249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11320 NW 43RD TER",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331784204",
            "telephone_number": "787-461-4719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11320 NW 43RD TER",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331784204",
            "telephone_number": "787-461-4719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ RESPETO",
        "first_name": "DANIEL",
        "middle_name": "J",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-08",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11021783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

Verify at the official NPI Registry.