Individual provider Active NPI

Annia Gonzalez Marull, APRN

  • Family Nurse Practitioner
  • Miami Gardens, FL
National Provider Identifier
1689215253
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11004360 Issued in FL
Practice address
1825 NW 167TH St Ste 108
Miami Gardens, FL 33056-4838
Phone
(305) 474-1803
Fax
(786) 629-3702
NPI assigned
Oct 3, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11004360 FL Primary
Pediatric Nurse Practitioner 363LP0200X APRN11004360 FL

Addresses

Primary practice location

1825 NW 167TH St Ste 108
Miami Gardens, FL 33056-4838

Mailing address

1825 NW 167TH St Ste 108
Miami Gardens, FL 33056-4838
Phone (305) 474-1803

Other identifiers 1

IdentifierTypeStateIssuer
105428400MedicaidFL

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
APRN11004360FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Family and Child Enrichment, Inc PastSince Mar 13, 2022 Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson, LLC PastSince Mar 1, 2020 Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson PastSince Mar 1, 2020 Accepting new patients

Organizations & group practices 3

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": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1689215253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 NW 167TH ST STE 108",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330564838",
            "telephone_number": "305-474-1803",
            "fax_number": "786-629-3702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 NW 167TH ST STE 108",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330564838",
            "telephone_number": "305-474-1803",
            "fax_number": "786-629-3702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ MARULL",
        "first_name": "ANNIA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-03",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11004360",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN11004360",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105428400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; 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.