Individual provider Active NPI

Angela Gamboa, OMT

  • Specialist
  • Tampa, FL
National Provider Identifier
1801677885
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
DH18124 Issued in FL
Practice address
807 W Lowry LN
Tampa, FL 33604-4711
Phone
(813) 368-2163
NPI assigned
Oct 6, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X DH18124 FL Primary

Addresses

Primary practice location

807 W Lowry LN
Tampa, FL 33604-4711

Mailing address

3702 W Spruce St # 1463
Tampa, FL 33607-2553
Phone (877) 662-1252

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DH18124FLMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1696550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1801677885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 W SPRUCE ST # 1463",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336072553",
            "telephone_number": "877-662-1252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 W LOWRY LN",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336044711",
            "telephone_number": "813-368-2163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBOA",
        "first_name": "ANGELA",
        "name_prefix": "Mrs.",
        "credential": "OMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-06",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "DH18124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 6, 2023; 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.