Active NPI
Mitchell J Guanzon, APRN
- Family Nurse Practitioner
- Melbourne, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN9453440
- Practice address
- 1350 Hickory St
Melbourne, FL 32901-3224 - Phone
- (321) 434-1771
- Fax
- (321) 434-1775
- NPI assigned
- Sep 12, 2018
- Last updated
- Jan 8, 2024
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN9453440 | FL | Primary |
| Hospitalist Physician | 208M00000X | APRN9453440 | FL |
Addresses
Primary practice location
1350 Hickory St
Melbourne, FL 32901-3224
Mailing address
3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (321) 434-1771
Other practice location 1
10794 Pines Blvd Ste 205
Pembroke Pines, FL 33026-3920
Phone (954) 538-8543
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 120325200 | Medicaid | FL | |
| SA763 | Other | FL | MEDICARE HF |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Florida International Univ, College of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
13755 Golf Club Pkwy
Fort Myers, FL 33919-5146
Phone (239) 482-2848
20900 Biscayne Blvd
Aventura, FL 33180-1407
Phone (305) 682-7000
3001 S Congress Ave
Boynton Beach, FL 33426-9012
Phone (561) 737-5600
4033 Beaver LN
Port Charlotte, FL 33952-9206
Phone (941) 625-3200
5245 N Socrum Loop Rd
Lakeland, FL 33809-4253
Phone (863) 859-1446
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Intensive Care Experts Health Network LLC | Current | Accepting new patients | |
| Intensive Care Experts Health Network LLC | Current | Accepting new patients | |
| Universal Health Corporation | Current | Accepting new patients | |
| Florida Hospital Medicine Services, LLC. | Hospitalist | Current | Accepting new patients |
Locations
9655 Boynton Beach Blvd
Boynton Beach, FL 33472
Phone (561) 336-7000
1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000
701 N Federal Hwy
Ste 601
Hallandale Beach, FL 33009
Phone (954) 573-2195
20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290
1945 Roanoke Blvd
Salem, VA 24153
Phone (540) 345-3094
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pulmonary Disease Physician
- Hallandale Beach, FL
- NPI 1164824397
-
dba Florida Acute Care Specialists (FLACS)
- Hospitalist Physician
- Boca Raton, FL
- NPI 1508873183
-
- Internal Medicine Physician
- Roanoke, VA
- NPI 1407117625
-
- Acute Care Nurse Practitioner
- Lawrenceburg, TN
- NPI 1184596637
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704672000000",
"number": "1992288278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 S FISKE BLVD",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329554306",
"telephone_number": "321-434-1771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 HICKORY ST",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329013224",
"telephone_number": "321-434-1771",
"fax_number": "321-434-1775"
}
],
"practiceLocations": [
{
"address_1": "10794 Pines Blvd Ste 205",
"address_purpose": "LOCATION",
"city": "Pembroke Pines",
"state": "FL",
"postal_code": "330263920",
"country_code": "US",
"telephone_number": "954-538-8543",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GUANZON",
"first_name": "MITCHELL",
"middle_name": "J",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-12",
"last_updated": "2024-01-08",
"certification_date": "2024-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "APRN9453440",
"primary": true
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "FL",
"license": "APRN9453440",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "120325200",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE HF",
"identifier": "SA763",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.