Individual provider Active NPI

Felix Armando Gonzalez-Quevedo, PA-C

  • Surgical Physician Assistant
  • Fort Lauderdale, FL
National Provider Identifier
1871501981
Registry record updated Mar 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA 9100805 Issued in FL
Practice address
6550 N Federal Hwy
Suite 512
Ft Lauderdale, FL 33308-1404
Phone
(954) 267-8777
Fax
(954) 772-7801
NPI assigned
Aug 4, 2006
Last updated
Mar 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA 9100805 FL Primary

Addresses

Primary practice location

6550 N Federal Hwy
Suite 512
Ft Lauderdale, FL 33308-1404

Mailing address

8940 SW 67TH Ave
Pinecrest, FL 33156-1708
Phone (305) 215-9033

Other practice location 1

3659 S Miami Ave Ste 4002
Miami, FL 33133-4231
Phone (305) 393-8810

Other identifiers 2

IdentifierTypeStateIssuer
2930137 00MedicaidFL
U1096YOtherFLMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 9100805FLMDSurgical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1871501981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8940 SW 67TH AVE",
            "city": "PINECREST",
            "state": "FL",
            "postal_code": "331561708",
            "telephone_number": "305-215-9033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 N FEDERAL HWY",
            "address_2": "SUITE 512",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333081404",
            "telephone_number": "954-267-8777",
            "fax_number": "954-772-7801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3659 S Miami Ave Ste 4002",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331334231",
            "country_code": "US",
            "telephone_number": "305-393-8810",
            "fax_number": "305-393-8811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ-QUEVEDO",
        "first_name": "FELIX",
        "middle_name": "ARMANDO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA 9100805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2930137 00",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "U1096Y",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.