Individual provider Active NPI

Alfredo Gonzalez-Vergara, M.D.

  • Family Medicine Physician
  • Miami Lakes, FL
National Provider Identifier
1790976371
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME100138 Issued in FL
Practice address
15225 NW 77TH Ave
Miami Lakes, FL 33014-7804
Phone
(305) 230-4821
Fax
(888) 498-3163
NPI assigned
Aug 7, 2007
Last updated
Oct 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME100138 FL Primary

Addresses

Primary practice location

15225 NW 77TH Ave
Miami Lakes, FL 33014-7804

Mailing address

860 NW 42ND Ave
FL 5
Miami, FL 33126
Phone (305) 504-7885

Other practice location 1

80 Wilson Blvd S Ste 11
Naples, FL 34117-9386
Phone (239) 208-5390

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081231000413 FL Practitioner - Family Practice 2062574940 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sunrise Medcare Center IncGroup PAC ID 6305232950, 2 clinicians

Practice addresses (Care Compare)

80 Wilson Blvd S
Suite 11
Naples, FL 34117-9386
Phone (239) 208-5990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME100138FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Univida Medical Center LLC CurrentSince Nov 1, 2023 Accepting new patients
Sunrise Medcare Center Inc Family Medicine CurrentSince Dec 23, 2021 Accepting new patients
Lehigh Hma Physician Management, LLC Family Medicine Past Accepting new patients
Continucare Medical Management Inc PastSince Mar 27, 2013 Accepting new patients

Locations

860 NW 42nd Ave
Fl 5
Miami, FL 33126
Phone (305) 504-7885

15225 NW 77th Ave
Miami Lakes, FL 33014
Phone (305) 230-4821

80 Wilson Blvd S
Ste 11
Naples, FL 34117
Phone (239) 208-5390

1800 N Douglas Rd
Pembroke Pines, FL 33024
Phone 3052040333 ext. 40333

6400 SW 8th St
West Miami, FL 33144
Phone (305) 239-2515

Interoperability endpoints

  • Direct secure messaging: alfredo.gonzalezvergara@univ.eclinicaldirectplus.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 5

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": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1790976371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 NW 42ND AVE",
            "address_2": "FL 5",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33126",
            "telephone_number": "305-504-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15225 NW 77TH AVE",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330147804",
            "telephone_number": "305-230-4821",
            "fax_number": "888-498-3163"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Wilson Blvd S Ste 11",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341179386",
            "country_code": "US",
            "telephone_number": "239-208-5390",
            "fax_number": "239-302-6813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ-VERGARA",
        "first_name": "ALFREDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-07",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME100138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

Verify at the official NPI Registry.