Individual provider Active NPI

Iliana Stenie Gonzalez

  • Child Intellectual and/or Developmental Disabilities Respite Care
  • Port St Lucie, FL
National Provider Identifier
1942408828
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X
Practice address
508 SE Whitmore Dr
Port St Lucie, FL 34984-4560
Phone
(772) 785-7110
Fax
(772) 785-7110
NPI assigned
Jul 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X Primary

Addresses

Primary practice location

508 SE Whitmore Dr
Port St Lucie, FL 34984-4560

Mailing address

508 SE Whitmore Dr
Port St Lucie, FL 34984-4560
Phone (772) 785-7110

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

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942408828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 SE WHITMORE DR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349844560",
            "telephone_number": "772-785-7110",
            "fax_number": "772-785-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 SE WHITMORE DR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349844560",
            "telephone_number": "772-785-7110",
            "fax_number": "772-785-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "ILIANA",
        "middle_name": "STENIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.