Leiden Ezequiel Gonzalez Pimentel, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ACN688 Issued in FL

Practice address

5425 S Florida Ave
Lakeland, FL 33813-2523

Phone

(863) 644-3585

Fax

(863) 644-3171

NPI assigned

Nov 26, 2010

Last updated

Oct 5, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

General Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Internal Medicine Care, PAGroup PAC ID 2466504386, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Advanced Internal Medicine Care, PA

  • Internal Medicine Physician
  • Lakeland, FL
  • NPI 1811130339

  General Practice

  Medicare reassignment Care Compare group NPD
• Allhealth LLC

  • Health Maintenance Organization
  • Lakeland, FL
  • NPI 1770023640
  NPD (past)

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

{
    "created_epoch": "1290729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444003200000",
    "number": "1801198791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132523",
            "telephone_number": "863-644-3585",
            "fax_number": "863-644-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132523",
            "telephone_number": "863-644-3585",
            "fax_number": "863-644-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ PIMENTEL",
        "first_name": "LEIDEN",
        "middle_name": "EZEQUIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-26",
        "last_updated": "2015-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "18095",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PR LICENSE",
            "identifier": "18095",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ACN688",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evelynn Gonsalves, LPN
• Esmeralda Gonzales, ARNP
• Maria de Jesus Gonzalez Cruz
• Mary Fernanda Gonzalez Fonseca, RBT-25-411073
• Waleska Gonzalez Martinez
• Anyeley Gonzalez Quintana
• Sofia Gonzalez Rubiano
• Hildaly Gonzalez Tecon
• Jorge L. Gonzalez-Cano, MD
• Francisco Gonzalez-Landron

• General Practice Physician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.