Individual provider Active NPI

Diana Gomez, MSN, FNP, APRN

  • Family Nurse Practitioner
  • Cape Coral, FL
National Provider Identifier
1639713043
Registry record updated Oct 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11004773 Issued in FL
Practice address
3407 SW 15TH Ave
Cape Coral, FL 33914-5185
Phone
(786) 219-6924
NPI assigned
Oct 30, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 11004773 FL Primary

Addresses

Primary practice location

3407 SW 15TH Ave
Cape Coral, FL 33914-5185

Mailing address

3407 SW 15TH Ave
Cape Coral, FL 33914-5185
Phone (786) 219-6924

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
I20200731002631 FL Practitioner - Nurse Practitioner 2163847559 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11004773FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Family Health LLC Single Specialty CurrentSince Jan 31, 2022 Accepting new patients

Locations

3208 Chiquita Blvd S
Ste 108
Cape Coral, FL 33914
Phone (239) 266-7319

2915 Colonial Blvd
Ste 220
Fort Myers, FL 33966
Phone (239) 313-3933

150 W McKenzie St
Ste 114
Punta Gorda, FL 33950
Phone (407) 288-0598

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1639713043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3407 SW 15TH AVE",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339145185",
            "telephone_number": "786-219-6924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3407 SW 15TH AVE",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339145185",
            "telephone_number": "786-219-6924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "DIANA",
        "credential": "MSN, FNP, APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11004773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.