Organization Active NPI

Family Medical Specialists of Florida PLC

  • Family Medicine Physician
  • Plant City, FL
National Provider Identifier
1427228998
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME93084 Issued in FL
Legal business name
FAMILY MEDICAL SPECIALISTS OF FLORIDA PLC
Practice address
1703 Thonotosassa Rd
Suite a
Plant City, FL 33563-4202
Phone
(813) 567-5679
Fax
(813) 567-5686
NPI assigned
Mar 11, 2008
Last updated
May 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2023

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

Authorized official

Name
Dr. Michael Paul Gimness, MDNPI 1518958222
Title
Medical Director
Phone
(813) 567-5679

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
Family Medicine Physician 207Q00000X ME93084 FL Primary

Addresses

Primary practice location

1703 Thonotosassa Rd
Suite a
Plant City, FL 33563-4202

Mailing address

1703 Thonotosassa Rd
Suite a
Plant City, FL 33563-4202
Phone (813) 567-5679

Other identifiers 1

IdentifierTypeStateIssuer
274338800MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080716000679 FL Part B Supplier - Clinic/Group Practice 5092888503 Receives reassigned benefits from 4 practitioners
Practice locations: Plant City, 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
10D1083898Family Medical Specialist of Florida PLC1703A Thonotosassa Rd, Plant City, FL 33563Certificate of waiverMay 12, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1205193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683849600000",
    "number": "1427228998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 THONOTOSASSA RD",
            "address_2": "SUITE A",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335634202",
            "telephone_number": "813-567-5679",
            "fax_number": "813-567-5686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 THONOTOSASSA RD",
            "address_2": "SUITE A",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335634202",
            "telephone_number": "813-567-5679",
            "fax_number": "813-567-5686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL SPECIALISTS OF FLORIDA PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-11",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A",
        "authorized_official_last_name": "GIMNESS",
        "authorized_official_first_name": "MICHAEL PAUL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "813-567-5679",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME93084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274338800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plant City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; 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.