MR. IBSEN FUNDORA GONZALEZ APRN NPI 1396354627

NPI Information

  • NPI: 1396354627
  • Provider Name: MR. IBSEN FUNDORA GONZALEZ, APRN
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 11270 PINES BLVD
    PEMBROKE PINES, FL
    ZIP 33026
  • Phone: (954) 628-5748

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NPI Details

MR. Ibsen Fundora Gonzalez, APRN is a family nurse practitioner in Pembroke Pines, FL. MR. Ibsen Fundora Gonzalez, APRN NPI is 1396354627. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

11270 PINES BLVD
PEMBROKE PINES, FL
ZIP 33026-101
Phone: (954) 628-5748

The NPI 1396354627 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/22/2020 and was last updated on 10/15/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthAPRN11008252FLORIDANo
2363LF0000XNurse PractitionerFamilyAPRN11008252FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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