Individual provider Active NPI

Cesar Antonio Boza Gaitan, MD

  • Family Medicine Physician
  • Brandon, FL
National Provider Identifier
1205569407
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME183058 Issued in FL
Practice address
500 Vonderburg Dr Ste 102
Brandon, FL 33511-5968
Phone
(813) 681-5658
Fax
(813) 681-5250
NPI assigned
Jul 5, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME183058 FL Primary

Addresses

Primary practice location

500 Vonderburg Dr Ste 102
Brandon, FL 33511-5968

Mailing address

500 Vonderburg Dr Ste 102
Brandon, FL 33511-5968
Phone (813) 681-5658

Other practice location 1

4051 Upper Creek Dr Ste 112
Sun City Center, FL 33573-6825
Phone (813) 681-5658

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Puerto Rico School of Medicine, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

500 Vonderburg Dr
Suite 102
Brandon, FL 33511-5968

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24523PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Medical Care of Brandon LLC CurrentSince Aug 3, 2026 Accepting new patients

Locations

500 Vonderburg Dr
Ste 102
Brandon, FL 33511
Phone (813) 386-2547

4051 Upper Creek Dr
Ste 112
Sun City Center, FL 33573
Phone (813) 681-5658

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1205569407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 VONDERBURG DR STE 102",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115968",
            "telephone_number": "813-681-5658",
            "fax_number": "813-681-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 VONDERBURG DR STE 102",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115968",
            "telephone_number": "813-681-5658",
            "fax_number": "813-681-5250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4051 Upper Creek Dr Ste 112",
            "address_purpose": "LOCATION",
            "city": "Sun City Center",
            "state": "FL",
            "postal_code": "335736825",
            "country_code": "US",
            "telephone_number": "813-681-5658",
            "fax_number": "813-681-5250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOZA GAITAN",
        "first_name": "CESAR",
        "middle_name": "ANTONIO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-05",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME183058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.