MEDICARE: MRS. TERESA MARIA GONGORA-GARCIA ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	364SF0001X	Family Health Clinical Nurse Specialist	ARNP 9256923	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0000000000	OTHER	FL	IN PROGRESS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770805699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TERESA MARIA GONGORA-GARCIA ARNP

Provider Business Mailing Address
First Line	:	983 SW 154TH PATH
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33194-2788
Country	:	US
Telephone Number	:	786-537-0618
Fax Number	:

Provider Business Practice Location Address
First Line	:	14283 SW 42ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-6408
Country	:	US
Telephone Number	:	305-226-1001
Fax Number	:	305-485-5529

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/18/2010
Last Update Date	:	01/23/2026

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