Individual provider Active NPI

Jalin Cimbaro

  • Pediatric Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1407503204
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
11018457 Issued in FL
Practice address
3100 E Fletcher Ave Ste 126
Tampa, FL 33613-4613
Phone
(813) 467-4242
NPI assigned
Mar 2, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X APRN11018457 FL
Pediatric Nurse Practitioner 363LP0200X 11018457 FL Primary

Addresses

Primary practice location

3100 E Fletcher Ave Ste 126
Tampa, FL 33613-4613

Mailing address

3100 E Fletcher Ave Ste 126
Tampa, FL 33613-4613
Phone (813) 467-4242

Other practice location 1

11948 Balm Riverview Rd
Riverview, FL 33569-6601
Phone (813) 236-9000

Other identifiers 2

IdentifierTypeStateIssuer
2MNMWOtherFLBLUE CROSS BLUE SHIELD
113764900MedicaidFL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240216000969 FL Practitioner - Nurse Practitioner 6305280488 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11018457FLMDPediatric Nurse Practitioner
APRN11018457FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Mar 11, 2024 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Mar 11, 2024 Accepting new patients
Weecare for Kids PA PastSince Jun 1, 2022 Accepting new patients
Privia Medical Group Florida, LLC PastSince Jun 1, 2022 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

3100 E Fletcher Ave
Ste 126
Tampa, FL 33613
Phone (813) 467-4242

Organizations & group practices 4

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": "1646179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1407503204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 E FLETCHER AVE STE 126",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134613",
            "telephone_number": "813-467-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 E FLETCHER AVE STE 126",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134613",
            "telephone_number": "813-467-4242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11948 Balm Riverview Rd",
            "address_purpose": "LOCATION",
            "city": "Riverview",
            "state": "FL",
            "postal_code": "335696601",
            "country_code": "US",
            "telephone_number": "813-236-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CIMBARO",
        "first_name": "JALIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-02",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN11018457",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "11018457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2MNMW",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113764900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.