Individual provider Active NPI

Antonio Labitag Gabarda, M.D.

  • Hematology & Oncology Physician
  • Port Charlotte, FL
National Provider Identifier
1104993849
Registry record updated Nov 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
ME45099 Issued in FL
Practice address
2525 Harbor Blvd
Suite 205
Port Charlotte, FL 33952-5317
Phone
(941) 629-4660
NPI assigned
Nov 29, 2006
Last updated
Nov 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X ME45099 FL Primary

Addresses

Primary practice location

2525 Harbor Blvd
Suite 205
Port Charlotte, FL 33952-5317

Mailing address

2525 Harbor Blvd
Suite 205
Port Charlotte, FL 33952-5317
Phone (941) 629-4660

Other identifiers 1

IdentifierTypeStateIssuer
0406627-00MedicaidFL

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME45099FLMDHematology & Oncology Physician
45099FLMDStudent in an Organized Health Care Education/Training Program

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227052800000",
    "number": "1104993849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 HARBOR BLVD",
            "address_2": "SUITE 205",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525317",
            "telephone_number": "941-629-4660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 HARBOR BLVD",
            "address_2": "SUITE 205",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525317",
            "telephone_number": "941-629-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABARDA",
        "first_name": "ANTONIO",
        "middle_name": "LABITAG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2008-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME45099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0406627-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2008; 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.