Ima Ebongo, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11001398 Issued in FL

Practice address

300 NW 183Rd St
Miami Gardens, FL 33169-4464

Phone

(305) 999-0520

NPI assigned

Nov 19, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Monef Health Services, Inc.

  • Home Health Registered Nurse
  • Miami Gardens, FL
  • NPI 1073563235
  NPD (past)

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1992341523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 NW 183RD ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331694464",
            "telephone_number": "305-999-0520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 NW 183RD ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331694464",
            "telephone_number": "305-999-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBONGO",
        "first_name": "IMA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-19",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11001398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dynamic Therapy & Rehabilitation Center
• E & E Medical Center Diagnostic Inc
• E Med Nursing Registry
• E. R. D. Medical Corp
• Easy Group Solutions, Inc
• Leidianys Echemendia
• Yanel Echemendia
• Liseth T Echevarria Filpes, SLP
• Edem Home Care
• Edwards Family Care Center Inc.

• Family Nurse Practitioner in Miami Gardens, FL
• Providers in Miami Gardens, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; 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.