Organization Active NPI

My Doctor Medical Group Corp

  • General Practice Physician
  • Tampa, FL
National Provider Identifier
1295237675
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MY DOCTOR MEDICAL GROUP CORP
Practice address
6822 W Waters Ave
Tampa, FL 33634-2212
Phone
(813) 280-4909
Fax
(813) 302-7143
NPI assigned
Mar 1, 2018
Last updated
Sep 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Authorized official

Name
Alejandro Gonzalez
Title
President
Phone
(813) 280-4909

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

6822 W Waters Ave
Tampa, FL 33634-2212

Mailing address

6822 W Waters Ave
Tampa, FL 33634-2212
Phone (813) 280-4909

Other practice location 1

888 S Parsons Ave
Brandon, FL 33511-6007
Phone (813) 697-1888

Other practice location 2

4821 US Highway 19 Ste 3
New Port Richey, FL 34652-4259
Phone (813) 280-4909

Other identifiers 1

IdentifierTypeStateIssuer
101345800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180430001241 FL Part B Supplier - Clinic/Group Practice 6305100371 Receives reassigned benefits from 8 practitioners
Practice locations: Brandon, FL; Tampa, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2163218My Doctor Medical Group Corp6822 W Waters Ave, Tampa, FL 33634Certificate of waiverMar 10, 2027
10D2270683My Doctor Medical Group Corp888 S Parsons Ave, Brandon, FL 33511Certificate of waiverOct 18, 2026

National Provider Directory

National Provider Directory

Locations

6822 W Waters Ave
Tampa, FL 33634
Phone (813) 280-4909

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19280/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1519862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788998400000",
    "number": "1295237675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6822 W WATERS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336342212",
            "telephone_number": "813-280-4909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6822 W WATERS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336342212",
            "telephone_number": "813-280-4909",
            "fax_number": "813-302-7143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "888 S Parsons Ave",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335116007",
            "country_code": "US",
            "telephone_number": "813-697-1888",
            "fax_number": "813-302-7143",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4821 US Highway 19 Ste 3",
            "address_purpose": "LOCATION",
            "city": "New Port Richey",
            "state": "FL",
            "postal_code": "346524259",
            "country_code": "US",
            "telephone_number": "813-280-4909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MY DOCTOR MEDICAL GROUP CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-01",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ALEJANDRO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-280-4909"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101345800",
            "state": "FL"
        }
    ],
    "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 Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.