Individual provider Active NPI

Gaelle Laurore-Fray, D.O.

  • Family Medicine Physician
  • Tampa, FL
National Provider Identifier
1740603547
Registry record updated May 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS 12507 Issued in FL
Practice address
4620 N 22ND St
Tampa, FL 33610-6205
Phone
(813) 272-6240
Fax
(813) 247-5591
NPI assigned
Jan 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS 12507 FL Primary

Addresses

Primary practice location

4620 N 22ND St
Tampa, FL 33610-6205

Mailing address

PO Box 82969
Tampa, FL 33682-2969
Phone (813) 866-0930

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
I20140619001261 FL Practitioner - Family Practice 1850515529 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tampa Family Specialty Services LLCGroup PAC ID 4284163718, 2 clinicians
Tampa Family Health Centers IncGroup PAC ID 1254243769, 66 clinicians

Practice addresses (Care Compare)

2727 W Dr Martin Luther King Jr Blvd
Suite 100
Tampa, FL 33607-6353

2727 W MLK Blvd
Suite 100a
Tampa, FL 33607-6353
Phone (813) 397-5300

4620 N 22ND St
Tampa, FL 33610-6205
Phone (813) 397-5300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS 12507FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa Family Health Centers Inc Current Accepting new patients
Tampa Family Specialty Services LLC Family Medicine CurrentSince Oct 1, 2024 Accepting new patients
Tampa Family Health Centers, Inc CurrentSince Jul 1, 2014 Accepting new patients
Tampa Family Health Centers Inc CurrentSince Jul 1, 2014 Accepting new patients

Locations

3513 Brighton Blvd
Ste 463
Denver, CO 80216

1212 E Bearss Ave
Lutz, FL 33549
Phone (813) 398-5300

12085 W Hillsborough Ave
Tampa, FL 33635
Phone (813) 852-5270

2727 W Mlk Blvd
Ste 100A
Tampa, FL 33607

302 W Fletcher Ave
Tampa, FL 33612

5611 Sheldon Rd
Tampa, FL 33615
Phone (813) 397-5320

4620 N 22nd St
Tampa, FL 33610
Phone (813) 272-6240

7814 N Dale Mabry Hwy
Tampa, FL 33614
Phone (813) 405-3939

8108 N Nebraska Ave
Tampa, FL 33604
Phone (813) 712-1930

8213 W Waters Ave
Tampa, FL 33615
Phone (813) 490-5420

4422 E Columbus Dr
Tampa, FL 33605
Phone (813) 384-4000

12410 N Nebraska Ave
Tampa, FL 33612

7608 Causeway Blvd
Tampa, FL 33619
Phone (813) 405-3710

6216 E Sligh Ave
Tampa, FL 33617
Phone (813) 549-8060

Organizations & group practices 4

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": "1390953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399593600000",
    "number": "1740603547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82969",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336822969",
            "telephone_number": "813-866-0930",
            "fax_number": "813-405-3924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 N 22ND ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336106205",
            "telephone_number": "813-272-6240",
            "fax_number": "813-247-5591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURORE-FRAY",
        "first_name": "GAELLE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-29",
        "last_updated": "2014-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS 12507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.