Mr Ibsen Fundora Gonzalez, APRN in Pembroke Pines, FL

Mr Ibsen Fundora Gonzalez, APRN is a medicare enrolled "Nurse Practitioner - Family" in Pembroke Pines, Florida. His current practice location is 11270 Pines Blvd, Pembroke Pines, Florida. You can reach out to his office (for appointments etc.) via phone at (954) 628-5748.

Mr Ibsen Fundora Gonzalez is licensed to practice in Florida (license number APRN11008252) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1396354627.

Contact Information

	Mr Ibsen Fundora Gonzalez, APRN
	11270 Pines Blvd, Pembroke Pines, FL 33026-4101
	(954) 628-5748
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Ibsen Fundora Gonzalez
Gender	Male
Speciality	Nurse Practitioner - Family
Location	11270 Pines Blvd, Pembroke Pines, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1396354627
Provider Enumeration Date: 07/22/2020
Last Update Date: 10/15/2025

Medicare PECOS Information:

PECOS PAC ID: 6901226711
Enrollment ID: I20201016001169

Medical Identifiers

Medical identifiers for Mr Ibsen Fundora Gonzalez such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1396354627	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	APRN11008252 (Florida)	Secondary
363LF0000X	Nurse Practitioner - Family	APRN11008252 (Florida)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Ibsen Fundora Gonzalez allows following entities to bill medicare on his behalf.

Entity Name	Total Orthopaedic Care Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1558317545 PECOS PAC ID: 6709852957 Enrollment ID: O20040908001365

Entity Name	Gold Diagnostics Corp
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1346824554 PECOS PAC ID: 2961802699 Enrollment ID: O20230113000057

Entity Name	Ezra Medical Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285404962 PECOS PAC ID: 1355787110 Enrollment ID: O20240314003382

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Ibsen Fundora Gonzalez is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Ibsen Fundora Gonzalez, APRN 11270 Pines Blvd, Pembroke Pines, FL 33026-4101 Ph: (561) 255-9330	Mr Ibsen Fundora Gonzalez, APRN 11270 Pines Blvd, Pembroke Pines, FL 33026-4101 Ph: (954) 628-5748

Reviews and Comments

Nurse Practitioner Nurses in Pembroke Pines, FL

Maria Antonieta Alfonso, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 9050 Pines Blvd Ste 150, Pembroke Pines, FL 33024 Phone: 954-872-0555 Fax: 954-256-6047
Elizabeth Martin Boada, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2213 N University Dr # A, Pembroke Pines, FL 33024 Phone: 954-963-2151
Anup Desai, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 880 Sw 145th Ave Ste 202, Pembroke Pines, FL 33027 Phone: 866-849-0692
Mariam Melina Tosado, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 17009 Pines Blvd, Pembroke Pines, FL 33027 Phone: 954-737-3158
Geo Thomas, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 13841 Nw 23rd St, Pembroke Pines, FL 33028 Phone: 954-529-4593
Mrs. Tricia A Riddle, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 880 Sw 145th Ave Ste 202, Pembroke Pines, FL 33027 Phone: 866-849-0692
Natalie Doyley-green, APRN, PMHNP-BC, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2010 Nw 150th Ave Ste 120, Pembroke Pines, FL 33028 Phone: 954-431-9838 Fax: 954-241-6726

Mr Ibsen Fundora Gonzalez, APRN - Medicare Nurse Practitioner in Pembroke Pines, FL