Organization Active NPI

Aurora Medical Group. Corp

  • Physical Medicine & Rehabilitation Physician
  • Tampa, FL
National Provider Identifier
1306487202
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
AURORA MEDICAL GROUP. CORP
Practice address
1419 W Waters Ave Ste 106
Tampa, FL 33604-2896
Phone
(813) 444-1600
Fax
(813) 295-8029
NPI assigned
Oct 1, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Authorized official

Name
Anisley Lanza Diaz, RN, BSN, MSNNPI 1336798156
Title
President
Phone
(813) 403-2567

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

1419 W Waters Ave Ste 106
Tampa, FL 33604-2896

Mailing address

1419 W Waters Ave Ste 106
Tampa, FL 33604-2896
Phone (813) 444-1600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210127000859 FL Part B Supplier - Clinic/Group Practice 2961816319 Receives reassigned benefits from 1 practitioner
Practice locations: Tampa, FL

National Provider Directory

National Provider Directory

Locations

2715 W Sligh Ave
Tampa, FL 33614
Phone (813) 403-2567

1419 W Waters Ave
Ste 106
Tampa, FL 33604
Phone (813) 444-1600

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769472000000",
    "number": "1306487202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 W WATERS AVE STE 106",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336042896",
            "telephone_number": "813-444-1600",
            "fax_number": "813-295-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 W WATERS AVE STE 106",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336042896",
            "telephone_number": "813-444-1600",
            "fax_number": "813-295-8029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AURORA MEDICAL GROUP. CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-01",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A",
        "authorized_official_last_name": "LANZA DIAZ",
        "authorized_official_first_name": "ANISLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-403-2567",
        "authorized_official_credential": "RN, BSN, MSN"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "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 Jan 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.