Individual provider Active NPI

Nelson Gonzalez Garcia

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1710642707
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11015578 Issued in FL
Practice address
10965 SW 69TH Dr
Miami, FL 33173-2009
Phone
(786) 797-0331
NPI assigned
Nov 3, 2021
Last updated
Nov 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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 11015578 FL Primary

Addresses

Primary practice location

10965 SW 69TH Dr
Miami, FL 33173-2009

Mailing address

10965 SW 69TH Dr
Miami, FL 33173-2009
Phone (786) 797-0331

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
I20211217000161 FL Practitioner - Nurse Practitioner 2769873207 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11015578FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Las Mercedes, LLC Single Specialty Current Accepting new patients
Clinica Las Mercedes, LLC CurrentSince Nov 4, 2024 Accepting new patients
Clinica Las Mercedes, LLC CurrentSince Nov 4, 2024 Accepting new patients

Locations

290 NE 8th St
Homestead, FL 33030
Phone (305) 537-4777

1479 NW 27th Ave
Miami, FL 33125
Phone (305) 633-3776

450 SW 136th Ave
Pembroke Pines, FL 33027
Phone (954) 239-4818

8251 W Broward Blvd
Ste 200210
Plantation, FL 33324
Phone (954) 334-3131

6355 NW 36th St
Ste 1100
Virginia Gardens, FL 33166

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, 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": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1710642707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10965 SW 69TH DR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331732009",
            "telephone_number": "786-797-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10965 SW 69TH DR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331732009",
            "telephone_number": "786-797-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ GARCIA",
        "first_name": "NELSON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-03",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11015578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.