Individual provider Active NPI

Gilberto L De Miranda, M.D.

  • General Practice Physician
  • Davenport, FL
National Provider Identifier
1316940943
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN1208 Issued in FL
Practice address
130 Ridge Center Dr Ste 104
Davenport, FL 33837-6414
Phone
(863) 421-9447
Fax
(863) 421-1806
NPI assigned
May 27, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 11202 PR
General Practice Physician 208D00000X ACN1208 FL Primary

Addresses

Primary practice location

130 Ridge Center Dr Ste 104
Davenport, FL 33837-6414

Mailing address

6675 Westwood Blvd Ste 475
Orlando, FL 32821-6027
Phone (407) 845-0330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR, FL2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060131000703 PR Practitioner - General Practice 3173537925 Practice locations: Santurce, PR
I20200226001080 FL Practitioner - General Practice 3173537925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Home Alliance, LLCGroup PAC ID 6406096536, 60 clinicians

Practice addresses (Care Compare)

130 Ridge Ctr Dr
Suite 104
Davenport, FL 33837-6414
Phone (863) 421-9447

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ACN1208FLMDGeneral Practice Physician
11202PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Home Alliance LLC CurrentSince Jan 5, 2026 Accepting new patients
Medical Home Alliance LLC CurrentSince Jan 5, 2026 Accepting new patients
Medical Home Alliance LLC Past Accepting new patients
Tender Loving Care Medical Inc Past Accepting new patients
Patient Medical Center of Florida Inc General Practice PastSince Apr 4, 2018 Accepting new patients
Metro Santurce, Inc. Past Accepting new patients
Cardiomax Corp Past Accepting new patients

Locations

130 Ridge Center Dr
Ste 104
Davenport, FL 33837
Phone (863) 421-9447

6675 Westwood Blvd
Ste 475
Orlando, FL 32821
Phone (407) 845-0384

199 Avenue K SE
Winter Haven, FL 33880
Phone (563) 588-1424

Organizations & group practices 7

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": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1316940943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6675 WESTWOOD BLVD STE 475",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328216027",
            "telephone_number": "407-845-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 RIDGE CENTER DR STE 104",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338376414",
            "telephone_number": "863-421-9447",
            "fax_number": "863-421-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE MIRANDA",
        "first_name": "GILBERTO",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "11202",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

Verify at the official NPI Registry.