Individual provider Active NPI

Vanessa I Gordon, ARNP

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1548387012
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP3204902 Issued in FL
Practice address
11880 SW 40TH St Ste 411
Miami, FL 33175-3575
Phone
(305) 223-1959
Fax
(305) 220-7102
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 ARNP3204902 FL Primary

Addresses

Primary practice location

11880 SW 40TH St Ste 411
Miami, FL 33175-3575

Mailing address

15832 SW 55TH Ter
Miami, FL 33185-5023
Phone (305) 606-9688

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
I20120919000450 FL Practitioner - Nurse Practitioner 4880697184 Practice locations: Miami, FL

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cano Health, LLC PastSince Apr 5, 2020 Accepting new patients
Intercare Home Health Services Inc PastSince Oct 24, 2005 Accepting new patients
Valerio Toyos, Mdpa PastSince Jan 1, 1998 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548387012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15832 SW 55TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331855023",
            "telephone_number": "305-606-9688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11880 SW 40TH ST STE 411",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753575",
            "telephone_number": "305-223-1959",
            "fax_number": "305-220-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "VANESSA",
        "middle_name": "I",
        "name_prefix": "Miss",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP3204902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.