Individual provider Active NPI

Daniela Gamba, PA-C

  • Physician Assistant
  • Brandon, FL
National Provider Identifier
1003569237
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAT9115529 Issued in FL
Practice address
671 S Kings Ave
Brandon, FL 33511-6048
Phone
(813) 972-3750
NPI assigned
Jan 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PAT9115529 FL Primary

Addresses

Primary practice location

671 S Kings Ave
Brandon, FL 33511-6048

Mailing address

406 N Hubert Ave Apt 302
Tampa, FL 33609-2111
Phone (561) 315-3721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PAT9115529FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Imad Al-Nakshabendi M D P a CurrentSince Feb 1, 2022 Accepting new patients

Locations

671 S Kings Ave
Brandon, FL 33511
Phone (813) 972-3750

Interoperability endpoints

  • Direct secure messaging: dgamba@floridaagc.amazing-direct.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1643328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1003569237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 N HUBERT AVE APT 302",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336092111",
            "telephone_number": "561-315-3721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "671 S KINGS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116048",
            "telephone_number": "813-972-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBA",
        "first_name": "DANIELA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-28",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PAT9115529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; 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.