Individual provider Active NPI

Gerald J Gallentine, OD

  • Optometrist
  • Tampa, FL
National Provider Identifier
1164417556
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OP1270 Issued in FL
Practice address
3338 S Dale Mabry Hwy
Tampa, FL 33629-7840
Phone
(813) 839-5399
Fax
(813) 831-3911
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OP1270 FL Primary

Addresses

Primary practice location

3338 S Dale Mabry Hwy
Tampa, FL 33629-7840

Mailing address

5125 N River Blvd
Tampa, FL 33603-1941
Phone (813) 237-4906

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

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1164417556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5125 N RIVER BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336031941",
            "telephone_number": "813-237-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3338 S DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336297840",
            "telephone_number": "813-839-5399",
            "fax_number": "813-831-3911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLENTINE",
        "first_name": "GERALD",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OP1270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.