Individual provider Active NPI

Debra Ann Gambini, RN

  • Registered Nurse
  • Winter Haven, FL
National Provider Identifier
1104105162
Registry record updated Aug 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN 9328676 Issued in FL
Practice address
1201 1St St S
Sweet Center
Winter Haven, FL 33880-3904
Phone
(863) 294-7062
Fax
(863) 291-5951
NPI assigned
Aug 9, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN 9328676 FL Primary
Registered Nurse 163W00000X 454540-1 NY

Addresses

Primary practice location

1201 1St St S
Sweet Center
Winter Haven, FL 33880-3904

Mailing address

200 Avenue F NE
Winter Haven, FL 33881-4131
Phone (863) 294-7062

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN 9328676FLMDRegistered Nurse
454540-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312848000000",
    "number": "1104105162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 AVENUE F NE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814131",
            "telephone_number": "863-294-7062",
            "fax_number": "863-291-5951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 1ST ST S",
            "address_2": "SWEET CENTER",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803904",
            "telephone_number": "863-294-7062",
            "fax_number": "863-291-5951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBINI",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-09",
        "last_updated": "2011-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN 9328676",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "454540-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; 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.