Individual provider Active NPI

Gisela Ulloa Fandino

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1669088605
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11008374 Issued in FL
Practice address
2215 NW 36TH St
Miami, FL 33142-5357
Phone
(786) 502-3857
Fax
(786) 391-3787
NPI assigned
Sep 16, 2020
Last updated
Aug 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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 11008374 FL Primary

Addresses

Primary practice location

2215 NW 36TH St
Miami, FL 33142-5357

Mailing address

2215 NW 36TH St
Miami, FL 33142-5357
Phone (786) 502-3857

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
I20260424000489 FL Practitioner - Nurse Practitioner 6709298813 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New Access Medical Center IncGroup PAC ID 4587070628, 2 clinicians
Wedo Medical Center CorpGroup PAC ID 0143617712, 2 clinicians

Practice addresses (Care Compare)

11981 SW 144TH CT
Suite 201
Miami, FL 33186-8653
Phone (786) 640-0609

2215 NW 36TH St
Miami, FL 33142-5357
Phone (786) 502-3857

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11008374FLMDFamily Nurse Practitioner

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": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1669088605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 NW 36TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331425357",
            "telephone_number": "786-502-3857",
            "fax_number": "786-931-3787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 NW 36TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331425357",
            "telephone_number": "786-502-3857",
            "fax_number": "786-391-3787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLOA FANDINO",
        "first_name": "GISELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-16",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11008374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.