Individual provider Active NPI

Denisse Fernandez- Goytizolo

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Jacksonville, FL
National Provider Identifier
1861897340
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
ME137214 Issued in FL
Practice address
841 Prudential Dr Ste 1400
Jacksonville, FL 32207-8364
Phone
(904) 396-5682
NPI assigned
Oct 27, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X ME137214 FL Primary

Addresses

Primary practice location

841 Prudential Dr Ste 1400
Jacksonville, FL 32207-8364

Mailing address

655 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-4046

Other practice location 1

234 E 149th St
Bronx, NY 10451-5504
Phone (718) 579-5030

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
I20201008003064 FL Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 6507142957 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME137214FLMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Oct 6, 2020 Accepting new patients
Paragon Emergency Services LLC Pediatric Emergency Medicine CurrentSince Oct 1, 2020 Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Oct 6, 2020 Accepting new patients
Emergency Physicians Inc CurrentSince Jan 11, 2023 Accepting new patients
University of Florida Jacksonville Physicians Inc Current Accepting new patients
Emergency Physicians Inc CurrentSince Jan 11, 2023 Accepting new patients

Locations

1250 S 18th St
Ste 202
Fernandina Beach, FL 32034
Phone (904) 202-2000

1747 Baptist Clay Dr
Ste 250
Fleming Isle, FL 32003
Phone (904) 516-1000

841 Prudential Dr
Ste 1400
Jacksonville, FL 32207
Phone (904) 202-2000

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

Interoperability endpoints

  • Direct secure messaging: dfernandezgoytizolo244518@direct.shands.ufl.edu

Organizations & group practices 6

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": "1414368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1861897340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-4046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 PRUDENTIAL DR STE 1400",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078364",
            "telephone_number": "904-396-5682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "234 E 149th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104515504",
            "country_code": "US",
            "telephone_number": "718-579-5030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDEZ- GOYTIZOLO",
        "first_name": "DENISSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-27",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "FL",
            "license": "ME137214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.