Individual provider Active NPI

Grivel Justina Hera Gomez, FNP

  • Family Nurse Practitioner
  • Hialeah, FL
National Provider Identifier
1508281908
Registry record updated Jul 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9302035 Issued in FL
Practice address
915 W 49TH St
Hialeah, FL 33012-3412
Phone
(305) 200-1225
NPI assigned
Feb 22, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2024

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 ARNP9302035 FL Primary

Addresses

Primary practice location

915 W 49TH St
Hialeah, FL 33012-3412

Mailing address

8324 NW 142ND St
Miami Lakes, FL 33016-5750
Phone (305) 793-8839

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
I20171023001101 FL Practitioner - Nurse Practitioner 7810263688 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9302035FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Medical Group of Florida PA CurrentSince Dec 23, 2021 Accepting new patients
Carbon Health Medical Group of Florida PA CurrentSince Dec 23, 2021 Accepting new patients

Locations

9162 Glades Rd
Boca Raton, FL 33434
Phone (561) 609-1119

8931 W Atlantic Blvd
Coral Springs, FL 33071
Phone (754) 225-7033

4825 SW 148th Ave
Davie, FL 33330
Phone (954) 526-7291

915 W 49th St
Hialeah, FL 33012
Phone (305) 200-1225

Networks

  • Freedom Health HMO Network

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": "1393027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720915200000",
    "number": "1508281908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8324 NW 142ND ST",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165750",
            "telephone_number": "305-793-8839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 W 49TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123412",
            "telephone_number": "305-200-1225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERA GOMEZ",
        "first_name": "GRIVEL",
        "middle_name": "JUSTINA",
        "name_prefix": "Miss",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-22",
        "last_updated": "2024-07-14",
        "certification_date": "2024-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9302035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.