Individual provider Active NPI

Abelardo Gotay Guzman

  • Renal Nutrition Registered Dietitian
  • Tampa, FL
National Provider Identifier
1912426008
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Renal Nutrition Registered DietitianTaxonomy code 133VN1005X
License
2043 Issued in PR
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

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2043OtherPROFFICE OF REGULATION AND CERTIFICATION OF HEATLH PROFESSIONALES OF PR
ND14169OtherFLFLORIDA DEPARTMENT OF HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
2043PRMDOral and Maxillofacial Surgery (Dentist)
0243PRMDNutritionist

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.