Active NPI
Abelardo Gotay Guzman
- Renal Nutrition Registered Dietitian
- Tampa, FL
National Provider Identifier
1912426008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Renal Nutrition Registered Dietitian
- License
- 2043
- Practice address
- 3166 Grand Pavilion Dr
Tampa, FL 33613-3722 - Phone
- (787) 244-6831
- NPI assigned
- Sep 11, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 0243 | PR | |
| Renal Nutrition Registered Dietitian | 133VN1005X | 2043 | PR | Primary |
Addresses
Primary practice location
3166 Grand Pavilion Dr
Tampa, FL 33613-3722
Mailing address
3166 Grand Pavilion Dr Unit 204
Tampa, FL 33613-3722
Phone (787) 244-6831
Other practice location 1
2826 Ave Dos Palmas
Toa Baja, PR 00949-4106
Phone (787) 261-5093
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2043 | Other | PR | OFFICE OF REGULATION AND CERTIFICATION OF HEATLH PROFESSIONALES OF PR |
| ND14169 | Other | FL | FLORIDA DEPARTMENT OF HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180320000803 | PR | Practitioner - Registered Dietitian Or Nutrition Professional | 3577825199 | Practice locations: Toa Baja, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2043 | PR | MD | Oral and Maxillofacial Surgery (Dentist) |
| 0243 | PR | MD | Nutritionist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Past | Accepting new patients |
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.
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- Registered Dietitian
- Austin, TX
- NPI 1558097824
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743984000000",
"number": "1912426008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3166 GRAND PAVILION DR UNIT 204",
"city": "TAMPA",
"state": "FL",
"postal_code": "336133722",
"telephone_number": "787-244-6831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3166 GRAND PAVILION DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336133722",
"telephone_number": "787-244-6831"
}
],
"practiceLocations": [
{
"address_1": "2826 Ave Dos Palmas",
"address_purpose": "LOCATION",
"city": "Toa Baja",
"state": "PR",
"postal_code": "009494106",
"country_code": "US",
"telephone_number": "787-261-5093",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOTAY GUZMAN",
"first_name": "ABELARDO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-09-11",
"last_updated": "2025-04-07",
"certification_date": "2025-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "PR",
"license": "0243",
"primary": false
},
{
"code": "133VN1005X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Renal",
"state": "PR",
"license": "2043",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OFFICE OF REGULATION AND CERTIFICATION OF HEATLH PROFESSIONALES OF PR",
"identifier": "2043",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA DEPARTMENT OF HEALTH",
"identifier": "ND14169",
"state": "FL"
}
],
"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 Apr 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.