Individual provider Active NPI

Jorge Gamoneda, SA-C

  • Surgical Assistant
  • Miami, FL
National Provider Identifier
1730519836
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
Practice address
3661 S Miami Ave
Suite 708
Miami, FL 33133
Phone
(305) 858-9879
NPI assigned
Nov 26, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Other Specialist/Technologist 246Z00000X 04-178 FL
Surgical Assistant 246ZC0007X FL Primary

Addresses

Primary practice location

3661 S Miami Ave
Suite 708
Miami, FL 33133

Mailing address

9804 SW 40TH St Ste 708
Miami, FL 33165-3912
Phone (305) 222-9154

Other practice location 1

1995 E Oakland Park Blvd Ste 310
Fort Lauderdale, FL 33306-1138
Phone (954) 791-6146

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
04-178FLMDOther Specialist/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Professional Surgical Services Current Accepting new patients
Florida Practitioners, LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1385424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1730519836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9804 SW 40TH ST STE 708",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331653912",
            "telephone_number": "305-222-9154",
            "fax_number": "305-222-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3661 S MIAMI AVE",
            "address_2": "SUITE 708",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33133",
            "telephone_number": "305-858-9879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1995 E Oakland Park Blvd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "333061138",
            "country_code": "US",
            "telephone_number": "954-791-6146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAMONEDA",
        "first_name": "JORGE",
        "credential": "SA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-26",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "FL",
            "license": "04-178",
            "primary": false
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.