NPIMap

Individual provider Active NPI

Gisela Torres-Bonilla, MD

  • Dermatology Physician
  • Tampa, FL
National Provider Identifier
1649362112
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME108096 Issued in FL
Practice address
4700 N Habana Ave Ste 303
Tampa, FL 33614-7118
Phone
(813) 341-3285
Fax
(813) 341-3284
NPI assigned
Sep 29, 2006
Last updated
Apr 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 35-088743 OH
Dermatology Physician 207N00000X ME108096 FL Primary

Addresses

Primary practice location

4700 N Habana Ave Ste 303
Tampa, FL 33614-7118

Mailing address

5210 Webb Rd
Tampa, FL 33615-4518
Phone (813) 882-9986

Other practice location 1

13321 N 56th St
Tampa, FL 33617-1161
Phone (813) 341-1488

Other identifiers 1

IdentifierTypeStateIssuer
024105000MedicaidFL

Other names 1

  • Gisela Torres Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-088743OHMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Leavitt Medical Associates of Florida Inc Dermatology Past Accepting new patients
Leavitt Medical Associates of Florida Inc Dermatology Past Accepting new patients
Center for Dermatology and Skin Surgery Inc Dermatology Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: gtorres-bonilla@directaddress.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1649362112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5210 WEBB RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336154518",
            "telephone_number": "813-882-9986",
            "fax_number": "813-341-3259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 N HABANA AVE STE 303",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147118",
            "telephone_number": "813-341-3285",
            "fax_number": "813-341-3284"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13321 N 56th St",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336171161",
            "country_code": "US",
            "telephone_number": "813-341-1488",
            "fax_number": "813-341-1489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TORRES-BONILLA",
        "first_name": "GISELA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35-088743",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME108096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024105000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GISELA",
            "last_name": "TORRES",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.