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NPI Code Detail

MEDICARE: YOVANY GONGORA MSN, APRN, FNP-C

MEDICARE: YOVANY GONGORA MSN, APRN, FNP-C
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
1363LF0000XFamily Nurse PractitionerAPRN11019813FL
2106S00000XBehavior TechnicianRBT-20-123140FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RBT20123140OTHERFLRBT

General Provider Information

NPI Number : 1962140434
Entity Type Code : Individual
Provider Name (Legal Business Name) : YOVANY GONGORA MSN, APRN, FNP-C
Provider Business Mailing Address
First Line : 11620 SW 185TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33157-6518
Country : US
Telephone Number : 786-660-1844
Fax Number : 305-564-7610
Provider Business Practice Location Address
First Line : 6405 NW 36TH ST STE 213
Second Line :
City : VIRGINIA GARDENS
State : FL
Zip : 33166-6973
Country : US
Telephone Number : 786-562-7479
Fax Number : 305-564-7610
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2022
Last Update Date : 06/11/2026

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