Individual provider Active NPI

Stacey Gonzalez

  • Acute Care Nurse Practitioner
  • Palm Beach Gardens, FL
National Provider Identifier
1619716164
Registry record updated Nov 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
11041688 Issued in FL
Practice address
3084 Grove Rd
Palm Beach Gardens, FL 33410-2440
Phone
(561) 846-9275
NPI assigned
May 23, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 11041688 FL Primary

Addresses

Primary practice location

3084 Grove Rd
Palm Beach Gardens, FL 33410-2440

Mailing address

3084 Grove Rd
Palm Beach Gardens, FL 33410-2440
Phone (561) 846-9275

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
I20251216004019 FL Practitioner - Nurse Practitioner 9436644556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT and Allergy Associates of Florida, LLCGroup PAC ID 0042292849, 227 clinicians

Practice addresses (Care Compare)

3401 Pga Blvd
Suite 410
Palm Beach Gardens, FL 33410-2825
Phone (361) 627-3773

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11041688FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
ENT and Allergy Associates of Florida, LLC CurrentSince Nov 24, 2025 Accepting new patients
Palm Beach Ear, Nose & Throat Association PA PastSince Nov 24, 2025 Accepting new patients

Locations

6421 Congress Ave
Ste 113
Boca Raton, FL 33487
Phone (561) 338-3267

900 NW 13th St
Ste 206
Boca Raton, FL 33486
Phone (561) 338-3267

3401 Pga Blvd
Ste 410
Palm Beach Gardens, FL 33410
Phone (361) 627-3773

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761955200000",
    "number": "1619716164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3084 GROVE RD",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334102440",
            "telephone_number": "561-846-9275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3084 GROVE RD",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334102440",
            "telephone_number": "561-846-9275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "STACEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-23",
        "last_updated": "2025-11-01",
        "certification_date": "2025-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "11041688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

Verify at the official NPI Registry.