Individual provider Active NPI

Teresa J Galdona-Gorassini, PAC

  • Physician Assistant
  • Miami, FL
National Provider Identifier
1891940474
Registry record updated Aug 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9104866 Issued in FL
Practice address
11211 SW 152ND St
Miami, FL 33157-1101
Phone
(305) 255-1355
Fax
(305) 255-2015
NPI assigned
Nov 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9104866 FL Primary

Addresses

Primary practice location

11211 SW 152ND St
Miami, FL 33157-1101

Mailing address

11211 SW 152ND St
Miami, FL 33157-1101
Phone (305) 255-1355

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
I20090409000195 FL Practitioner - Physician Assistant 8224185269 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Plaza Medical Centers Corp CurrentSince Mar 30, 2011 Accepting new patients
PMC Hillsboro, LLC CurrentSince Apr 1, 2014 Accepting new patients
PMC Plantation LLC CurrentSince Nov 8, 2018 Accepting new patients
PMC West Oakland Park LLC CurrentSince Mar 30, 2011 Accepting new patients
Carlos M Alonso MD PA PastSince Nov 27, 2022 Accepting new patients

Locations

1500 E Hillsboro Blvd
Ste 210
Deerfield Beach, FL 33441
Phone (954) 419-9632

11211 SW 152nd St
Miami, FL 33157
Phone (305) 255-1355

1806 N Pine Island Rd
Plantation, FL 33322
Phone (954) 474-0110

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": "1227484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313452800000",
    "number": "1891940474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11211 SW 152ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331571101",
            "telephone_number": "305-255-1355",
            "fax_number": "305-255-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11211 SW 152ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331571101",
            "telephone_number": "305-255-1355",
            "fax_number": "305-255-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALDONA-GORASSINI",
        "first_name": "TERESA",
        "middle_name": "J",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-24",
        "last_updated": "2011-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.