Michael David Gaynor, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME40882 Issued in FL

Practice address

3638 Madaca Lane
Tampa, FL 33618

Phone

(813) 968-6610

Fax

(813) 264-1669

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Pediatric Health Care Alliance, PA

  • Pediatrics Physician
  • Oldsmar, FL
  • NPI 1609965441
  NPD (past)
• Pediatric Health Care Alliance, PA

  • Pediatrics Physician
  • Tampa, FL
  • NPI 1750057527
  NPD (past)

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1154347078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4033 TAMPA RD STE 101",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346773224",
            "telephone_number": "813-854-2003",
            "fax_number": "813-436-5378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3638 MADACA LANE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33618",
            "telephone_number": "813-968-6610",
            "fax_number": "813-264-1669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYNOR",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME40882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043829404",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Michael Gavula
• Jeralyn Gay
• Wawie Gay
• Isis Wadie Gayed, M.D.
• Daisy Gaynor
• Juan Antonio Gaytan Gonzalez, APRN FNP
• Yolanda Gaytan
• Joy E Gaziano, MA, SLP
• Victor Pasko Gazivoda, MD
• Margaret Gearing-Small, LCSW

• Pediatrics Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.