Active NPI
Jose Gerena
- Adult Companion
- Riverview, FL
National Provider Identifier
1902202377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- License
- 233767
- Practice address
- 11325 Village Brook Dr
Riverview, FL 33579 - Phone
- (888) 501-2586
- NPI assigned
- Nov 13, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Companion | 372600000X | 233767 | FL | Primary |
| Homemaker | 376J00000X | 233767 | FL |
Addresses
Primary practice location
11325 Village Brook Dr
Riverview, FL 33579
Mailing address
3680 Lake Center Dr 1104
Mt Dora, FL 32757
Phone (888) 501-2586
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 233767 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 233767 | FL | MD | Adult Companion |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415836800000",
"number": "1902202377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3680 LAKE CENTER DR 1104",
"city": "MT DORA",
"state": "FL",
"postal_code": "32757",
"telephone_number": "888-501-2586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11325 VILLAGE BROOK DR",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "33579",
"telephone_number": "888-501-2586"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERENA",
"first_name": "JOSE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-11-13",
"last_updated": "2014-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": "FL",
"license": "233767",
"primary": true
},
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": "FL",
"license": "233767",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "233767",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Riverview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.