Individual provider Active NPI

Marcia Delorme Gayoso, M.D.

  • Pediatrics Physician
  • Orlando, FL
National Provider Identifier
1891745576
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME0084749 Issued in FL
Practice address
815 Woodbury Rd
Suite #102
Orlando, FL 32828-4515
Phone
(407) 208-9870
Fax
(407) 208-9868
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME0084749 FL Primary

Addresses

Primary practice location

815 Woodbury Rd
Suite #102
Orlando, FL 32828-4515

Mailing address

815 Woodbury Rd
Suite #102
Orlando, FL 32828-4515
Phone (407) 208-9870

Other identifiers 1

IdentifierTypeStateIssuer
000584800MedicaidFL

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0084749FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Vista Pediatrics Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: marcia.gayoso@ip-fl.direct.office.nextgen.com
  • Direct secure messaging: marcia.gayoso@direct.meditouchehr.com

Organizations & group practices 1

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1891745576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 WOODBURY RD",
            "address_2": "SUITE #102",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328284515",
            "telephone_number": "407-208-9870",
            "fax_number": "407-208-9868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 WOODBURY RD",
            "address_2": "SUITE #102",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328284515",
            "telephone_number": "407-208-9870",
            "fax_number": "407-208-9868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYOSO",
        "first_name": "MARCIA",
        "middle_name": "DELORME",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME0084749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000584800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; 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.