Individual provider Active NPI

Rafael Emilse Rondon Gonzalez, APRN

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1669178059
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11023678 Issued in FL
Practice address
10905 Bent Tree PL
Tampa, FL 33618-4116
Phone
(813) 808-9165
NPI assigned
Feb 7, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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 11023678 FL Primary

Addresses

Primary practice location

10905 Bent Tree PL
Tampa, FL 33618-4116

Mailing address

10905 Bent Tree PL
Tampa, FL 33618-4116
Phone (813) 808-9165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11023678FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1675728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1669178059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10905 BENT TREE PL",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336184116",
            "telephone_number": "813-808-9165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10905 BENT TREE PL",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336184116",
            "telephone_number": "813-808-9165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONDON GONZALEZ",
        "first_name": "RAFAEL",
        "middle_name": "EMILSE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-07",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11023678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.