Laura Megan Gwilliam

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9116051 Issued in FL

Practice address

15415 Plantation Oaks Dr Apt 3
Tampa, FL 33647-2152

Phone

(941) 374-0457

NPI assigned

Jan 27, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Observation Medical Group LLC

  • Emergency Medicine Physician
  • Tampa, FL
  • NPI 1952763682
  Medicare reassignment NPD
• Emergency Medical Associates of Tampa Bay, LLC

  • Emergency Medicine Physician
  • Tampa, FL
  • NPI 1023397817
  Medicare reassignment

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1306477666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 W SAINT ISABEL ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15415 PLANTATION OAKS DR APT 3",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472152",
            "telephone_number": "941-374-0457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWILLIAM",
        "first_name": "LAURA",
        "middle_name": "MEGAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-27",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nestor J Guzman, PHARMD
• Oscar Guzman, PHARMD
• Susan Nathalie Guzman, PA
• Bridget Terranella Guzzardo, CRNA
• Regina Guzzo, MD
• Tammy Prince Gwozdz, ARNP
• Richard Gyles, DDS
• GYN Network, LLC
• Kailyn Gyorkos
• Gloria Gysbertsen, ARNP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.