Individual provider Active NPI

Alida Pena Gonzalez, ARNP

  • Family Nurse Practitioner
  • Wauchula, FL
National Provider Identifier
1982173845
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11000014 Issued in FL
Practice address
515 Carlton St
Wauchula, FL 33873-3407
Phone
(863) 773-6606
Fax
(863) 773-9542
NPI assigned
Nov 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11000014 FL Primary

Addresses

Primary practice location

515 Carlton St
Wauchula, FL 33873-3407

Mailing address

882 Terrier Dr
Zolfo Springs, FL 33890-9516
Phone (786) 280-8495

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
I20200206001817 FL Practitioner - Nurse Practitioner 6507292786 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adventist Health System-Sunbelt IncGroup PAC ID 0749232445, shared by 8 NPIs, 100 clinicians

Practice addresses (Care Compare)

515 Carlton St
Wauchula, FL 33873-3407
Phone (863) 773-6606

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System-Sunbelt Inc Family CurrentSince Dec 15, 2019 Accepting new patients
Adventist Health System-Sunbelt Inc CurrentSince Dec 15, 2019 Accepting new patients
Adventist Health System-Sunbelt Inc Current Accepting new patients
Adventist Health System-Sunbelt Inc CurrentSince Dec 15, 2019 Accepting new patients

Locations

200 S Scenic Hwy
Frostproof, FL 33843
Phone (863) 453-3121

1210 US Highway 27 N
Lake Placid, FL 33852
Phone (863) 465-3777

515 Carlton St
Wauchula, FL 33873
Phone (863) 773-6606

Interoperability endpoints

  • Direct secure messaging: apenagonzalez617874@adventhealth.direct-ci.com

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 7

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": "1542672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1982173845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "882 TERRIER DR",
            "city": "ZOLFO SPRINGS",
            "state": "FL",
            "postal_code": "338909516",
            "telephone_number": "786-280-8495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 CARLTON ST",
            "city": "WAUCHULA",
            "state": "FL",
            "postal_code": "338733407",
            "telephone_number": "863-773-6606",
            "fax_number": "863-773-9542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA GONZALEZ",
        "first_name": "ALIDA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-20",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11000014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauchula, FL

Sources for this page

Verify at the official NPI Registry.