Individual provider Active NPI

Greta Giselle Gonzalez, APRN

  • Primary Care Nurse Practitioner
  • Sunny Isles Beach, FL
National Provider Identifier
1528753571
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
11018168 Issued in FL
Practice address
290 174TH St Apt 1017
Sunny Isles Beach, FL 33160-3250
Phone
(305) 332-5675
NPI assigned
Apr 6, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 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 11018168 FL Primary

Addresses

Primary practice location

290 174TH St Apt 1017
Sunny Isles Beach, FL 33160-3250

Mailing address

290 174TH St Apt 1017
Sunny Isles Beach, FL 33160-3250
Phone (305) 332-5675

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
I20230823002960 FL Practitioner - Nurse Practitioner 4183087174 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11018168FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oscar Herrera MD PA CurrentSince Jul 15, 2023 Accepting new patients

Locations

2525 SW 75th Ave
Miami, FL 33155
Phone (305) 260-1852

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": "1680739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1528753571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 174TH ST APT 1017",
            "city": "SUNNY ISLES BEACH",
            "state": "FL",
            "postal_code": "331603250",
            "telephone_number": "305-332-5675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 174TH ST APT 1017",
            "city": "SUNNY ISLES BEACH",
            "state": "FL",
            "postal_code": "331603250",
            "telephone_number": "305-332-5675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "GRETA",
        "middle_name": "GISELLE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-06",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "11018168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunny Isles Beach, FL

Sources for this page

Verify at the official NPI Registry.