Individual provider Active NPI

Mario Michel Gomez Hernandez, APRN

  • Family Nurse Practitioner
  • Coral Gables, FL
National Provider Identifier
1962923375
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11027912 Issued in FL
Practice address
5555 Ponce de Leon Blvd
Coral Gables, FL 33146-2513
Phone
(305) 243-2424
NPI assigned
Jul 6, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-21-53906 FL
Family Nurse Practitioner 363LF0000X APRN11027912 FL Primary

Addresses

Primary practice location

5555 Ponce de Leon Blvd
Coral Gables, FL 33146-2513

Mailing address

5555 Ponce de Leon Blvd
Coral Gables, FL 33146-2513
Phone (305) 243-2424

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
I20240320000260 FL Practitioner - Nurse Practitioner 8628415122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of MiamiGroup PAC ID 3274795109, 2,346 clinicians

Practice addresses (Care Compare)

5555 Ponce de Leon Blvd
Coral Gables, FL 33146-2513
Phone (305) 689-8648

Hospital & facility affiliations

  • Univ of Miami Hospital and Clinics-Sylvester Compr Hospital, Miami, FL, CCN 100079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11027912FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Current Accepting new patients
University of Miami CurrentSince Mar 1, 2024 Accepting new patients
University of Miami Nurse Practitioner CurrentSince Mar 1, 2024 Accepting new patients
University of Miami Past Accepting new patients

Locations

5555 Ponce de Leon Blvd
Coral Gables, FL 33146
Phone (305) 585-1052

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

2801 NW 79th Ave
Miami, FL 33122
Phone (786) 466-1000

1801 NW 9th Ave
Fl 6
Miami, FL 33136
Phone (305) 355-5006

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1120 NW 14th St
Miami, FL 33136
Phone (305) 243-2000

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mgomezhernandez132306@direct.med.miami.edu

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1499299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1962923375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 PONCE DE LEON BLVD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462513",
            "telephone_number": "305-243-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 PONCE DE LEON BLVD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462513",
            "telephone_number": "305-243-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ HERNANDEZ",
        "first_name": "MARIO",
        "middle_name": "MICHEL",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-06",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-21-53906",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11027912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.