Individual provider Active NPI

Moira Del Mar Gonzalez Samot, DC

  • Chiropractor
  • Lehigh Acres, FL
National Provider Identifier
1508670514
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH15261 Issued in FL
Practice address
403 Joan Ave N
Lehigh Acres, FL 33971-1941
Phone
(239) 369-9109
NPI assigned
Feb 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH15261 FL Primary

Addresses

Primary practice location

403 Joan Ave N
Lehigh Acres, FL 33971-1941

Mailing address

705 Christina Lake Dr
Lakeland, FL 33813-3571
Phone (787) 989-3686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250305003639 FL Practitioner - Chiropractic 6608397732 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Specific Care Chiropractic Inc Chiropractor CurrentSince Feb 14, 2025 Accepting new patients

Locations

3949 Evans Ave
Ste 406
Fort Myers, FL 33901
Phone (239) 288-7274

403 Joan Ave N
Lehigh Acres, FL 33971
Phone (239) 369-9101

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": "1738540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1508670514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 CHRISTINA LAKE DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338133571",
            "telephone_number": "787-989-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 JOAN AVE N",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339711941",
            "telephone_number": "239-369-9109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ SAMOT",
        "first_name": "MOIRA",
        "middle_name": "DEL MAR",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH15261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.