Individual provider Active NPI

Mitchell J Guanzon, APRN

  • Family Nurse Practitioner
  • Melbourne, FL
National Provider Identifier
1992288278
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9453440 Issued in FL
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, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
120325200MedicaidFL
SA763OtherFLMEDICARE HF

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181214002629 FL Practitioner - Nurse Practitioner 8527303882 Reassigns benefits to 2 organizations
I20241114003089 VA Practitioner - Nurse Practitioner 8527303882 Reassigns benefits to 1 organization

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

OrganizationSpecialtyStatusNew patients
Intensive Care Experts Health Network LLC CurrentSince Jul 20, 2025 Accepting new patients
Intensive Care Experts Health Network LLC CurrentSince Jul 20, 2025 Accepting new patients
Universal Health Corporation CurrentSince Sep 14, 2024 Accepting new patients
Florida Hospital Medicine Services, LLC. Hospitalist CurrentSince Dec 1, 2023 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.

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

Verify at the official NPI Registry.