Individual provider Active NPI

Alex Garrido-Zambrano, M.D.

  • Family Medicine Physician
  • Clearwater, FL
National Provider Identifier
1720242480
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
62998 Issued in TN
Practice address
14100 58TH St N
Clearwater, FL 33760-9900
Phone
(727) 824-8181
NPI assigned
Jul 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11014175A IN
Family Medicine Physician 207Q00000X 036130699 IL
Family Medicine Physician 207Q00000X 62998 TN Primary

Addresses

Primary practice location

14100 58TH St N
Clearwater, FL 33760-9900

Mailing address

14100 58TH St N
Clearwater, FL 33760-9900
Phone (727) 824-8181

Other identifiers 6

IdentifierTypeStateIssuer
370966854002MedicaidIL
036130699MedicaidIL
370966854004MedicaidIL
Q067710MedicaidTN
370966854005MedicaidIL
CF3444OtherILMEDICARE RR

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
I20240821001687 FL Practitioner - Family Practice 5395994487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

14100 58TH St N
Clearwater, FL 33760-9900
Phone (727) 824-8181

5523 Roosevelt Blvd
Clearwater, FL 33760-3425
Phone (727) 824-8181

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11014175AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center of Pinellas Inc Family Medicine Current Accepting new patients
Community Health Center of Pinellas Inc Family Medicine CurrentSince Aug 8, 2024 Accepting new patients
Community Health Centers of Pinellas Inc. CurrentSince Aug 8, 2024 Accepting new patients
Shawnee Health Service and Development Corp Family Medicine Past Accepting new patients
Housecall Primary Care, PLLC PastSince Jul 15, 2021 Accepting new patients
Shawnee Health Service and Development Corp Family Medicine Past Accepting new patients
Shawnee Health Service and Development Corp Family Medicine Past Accepting new patients

Locations

14100 58th St N
Ste 100
Clearwater, FL 33760
Phone (727) 286-6224

5523 Roosevelt Blvd
Clearwater, FL 33760

14100 58th St N
Clearwater, FL 33760

9064 NW 13th Ter
Doral, FL 33172
Phone (305) 801-6989

Organizations & group practices 7

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": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1720242480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14100 58TH ST N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337609900",
            "telephone_number": "727-824-8181",
            "fax_number": "727-895-3762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14100 58TH ST N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337609900",
            "telephone_number": "727-824-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRIDO-ZAMBRANO",
        "first_name": "ALEX",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-11",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11014175A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036130699",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "62998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370966854002",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036130699",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370966854004",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q067710",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370966854005",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "CF3444",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.