Endoone Diabetes & Endocrinology Center, LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

ENDOONE DIABETES & ENDOCRINOLOGY CENTER, LLC

Practice address

602 S Audubon Ave Ste a
Tampa, FL 33609-4217

Phone

(813) 931-2424

Fax

(813) 869-3148

NPI assigned

Dec 6, 2023

Last updated

Aug 22, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gustavo Antonio Meyreles Chaljub, MDNPI 1700325479

Title

MD

Phone

(813) 931-2424

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gustavo Antonio Meyreles-Chaljub, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Tampa, FL
  • NPI 1700325479
  Medicare reassignment Care Compare group NPD Authorized official
• Madeline Candelario-Cosme, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Tampa, FL
  • NPI 1144595406
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1701820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724284800000",
    "number": "1053188417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 S AUDUBON AVE STE A",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 S AUDUBON AVE STE A",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094217",
            "telephone_number": "813-931-2424",
            "fax_number": "813-869-3148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOONE DIABETES & ENDOCRINOLOGY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-06",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A",
        "authorized_official_last_name": "MEYRELES CHALJUB",
        "authorized_official_first_name": "GUSTAVO",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "813-931-2424",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121617900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Tampa, FL
• Providers in Tampa, FL by specialty
• Medical Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.