Organization Active NPI

Bigbend Pediatric Care, LLC

  • Pediatrics Physician
  • Gibsonton, FL
National Provider Identifier
1578908968
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
BIGBEND PEDIATRIC CARE, LLC
Practice address
13147 Kings Lake Dr
Suite 101
Gibsonton, FL 33534-3959
Phone
(813) 672-6092
Fax
(813) 280-9098
NPI assigned
Apr 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Authorized official

Name
Rolando GarciaNPI 1174641732
Title
Owner
Phone
(813) 672-6092

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

13147 Kings Lake Dr
Suite 101
Gibsonton, FL 33534-3959

Mailing address

13147 Kings Lake Dr
Suite 101
Gibsonton, FL 33534-3959
Phone (813) 672-6092

Other identifiers 1

IdentifierTypeStateIssuer
110510700MedicaidFL

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
10D2029096Bigbend Pediatric Care LLC13147 Kings Lake Drive, Suite 101, Gibsonton, FL 33534Certificate of waiverAug 30, 2027

National Provider Directory

National Provider Directory

Locations

13131 Kings Lake Dr
Unit 101
Gibsonton, FL 33534
Phone (813) 672-6092

Practitioners & affiliated clinicians

Practitioners 1

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": "1367280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777420800000",
    "number": "1578908968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13147 KINGS LAKE DR",
            "address_2": "SUITE 101",
            "city": "GIBSONTON",
            "state": "FL",
            "postal_code": "335343959",
            "telephone_number": "813-672-6092",
            "fax_number": "813-280-9098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13147 KINGS LAKE DR",
            "address_2": "SUITE 101",
            "city": "GIBSONTON",
            "state": "FL",
            "postal_code": "335343959",
            "telephone_number": "813-672-6092",
            "fax_number": "813-280-9098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIGBEND PEDIATRIC CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-30",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "ROLANDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-672-6092"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110510700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gibsonton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.