Individual provider Active NPI

Thresia B Gambon, MD

  • Pediatrics Physician
  • Hialeah, FL
National Provider Identifier
1508800244
Registry record updated Dec 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME0072798 Issued in FL
Practice address
551 West 51St Place
Citrus Health Network Inc
Hialeah, FL 33012-3300
Phone
(305) 817-6560
Fax
(786) 209-2030
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME0072798 FL Primary

Addresses

Primary practice location

551 West 51St Place
Citrus Health Network Inc
Hialeah, FL 33012-3300

Mailing address

551 West 51St Place
Citrus Health Network Inc
Hialeah, FL 33012-3300
Phone (305) 817-6560

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051017000973 FL Practitioner - Pediatric Medicine 1850317025 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0072798FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Citrus Health Network, Inc. CurrentSince Nov 19, 2016 Accepting new patients
Citrus Health Network Inc Current Accepting new patients
Citrus Health Network Inc CurrentSince Nov 19, 2016 Accepting new patients
University of Miami Pediatrics Past Accepting new patients
University of Miami Past Accepting new patients
Public Health Trust of Miami Dade County Florida Past Accepting new patients
Public Health Trust of Miami Dade County Florida Past Accepting new patients
Citrus Health Network Inc Past Accepting new patients

Locations

4175 W 20th Ave
Hialeah, FL 33012
Phone (305) 424-3030

551 W 51st Pl
Hialeah, FL 33012
Phone (305) 817-6560

551 W 51st Pl
Fl 2
Hialeah, FL 33012
Phone (305) 817-6560

Organizations & group practices 8

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386806400000",
    "number": "1508800244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 WEST 51ST PLACE",
            "address_2": "CITRUS HEALTH NETWORK INC",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123300",
            "telephone_number": "305-817-6560",
            "fax_number": "786-209-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 WEST 51ST PLACE",
            "address_2": "CITRUS HEALTH NETWORK INC",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123300",
            "telephone_number": "305-817-6560",
            "fax_number": "786-209-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBON",
        "first_name": "THRESIA",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2013-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME0072798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.