NPIMap

Individual provider Active NPI

Vimayla E Gonzalez, M. D.

  • Internal Medicine Physician
  • Clermont, FL
National Provider Identifier
1598994055
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME118365 Issued in FL
Practice address
3190 Citrus Tower Blvd Ste B
Clermont, FL 34711-6886
Phone
(352) 242-2282
Fax
(352) 242-2886
NPI assigned
Jul 6, 2009
Last updated
May 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME118365 FL
Internal Medicine Physician 207R00000X ME118365 FL Primary

Addresses

Primary practice location

3190 Citrus Tower Blvd Ste B
Clermont, FL 34711-6886

Mailing address

3190 Citrus Tower Blvd Ste B
Clermont, FL 34711-6886
Phone (352) 242-2282

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140408001754 FL Practitioner - Internal MedicinePractitioner - Family Practice 5193957025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Aegis Medical Group LLCGroup PAC ID 8022324862, 20 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

3725 S Hwy 27
Suite 101
Clermont, FL 34711-7600
Phone (352) 242-0676

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME118365FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Medical Group LLC Internal Medicine CurrentSince May 2, 2023 Accepting new patients
Optumcare Florida Ci, LLC Past Accepting new patients

Locations

3190 Citrus Tower Blvd
Ste B
Clermont, FL 34711
Phone (352) 242-2282

3725 S Highway 27
Ste 101
Clermont, FL 34711
Phone (352) 242-0676

410 Fern Dr
Leesburg, FL 34748
Phone (352) 218-8200

18550 US Highway 441
Mount Dora, FL 32757
Phone (352) 735-3755

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JBDHAD

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

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1598994055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3190 CITRUS TOWER BLVD STE B",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116886",
            "telephone_number": "352-242-2282",
            "fax_number": "352-242-2886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3190 CITRUS TOWER BLVD STE B",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116886",
            "telephone_number": "352-242-2282",
            "fax_number": "352-242-2886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "VIMAYLA",
        "middle_name": "E",
        "credential": "M. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-06",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME118365",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME118365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.