Individual provider Active NPI

Sandra Gomez

  • Nurse Practitioner
  • Miami Lakes, FL
National Provider Identifier
1760193866
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11023258 Issued in FL
Practice address
8843 NW 150TH St
Miami Lakes, FL 33018-1318
Phone
(786) 231-8566
NPI assigned
Dec 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11023258 FL Primary

Addresses

Primary practice location

8843 NW 150TH St
Miami Lakes, FL 33018-1318

Mailing address

8843 NW 150TH St
Miami Lakes, FL 33018-1318
Phone (786) 231-8566

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
I20230424001105 FL Practitioner - Nurse Practitioner 9830554088 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11023258FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Enzo L Abad DO PL CurrentSince Mar 1, 2023 Accepting new patients

Locations

182 E 49th St
Hialeah, FL 33013
Phone (305) 512-4460

2001 W 68th St
Miami Lakes, FL 33016
Phone (305) 364-2151

Organizations & group practices 1

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": "1670457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1760193866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8843 NW 150TH ST",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330181318",
            "telephone_number": "786-231-8566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8843 NW 150TH ST",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330181318",
            "telephone_number": "786-231-8566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "SANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-08",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11023258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

Verify at the official NPI Registry.