Individual provider Active NPI

Carlos Tod Pairazaman

  • Gerontology Nurse Practitioner
  • Brandon, FL
National Provider Identifier
1922808286
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN11038027 Issued in FL
Practice address
621 W Lumsden Rd
Brandon, FL 33511-5911
Phone
(813) 755-3500
Fax
(813) 755-3300
NPI assigned
Mar 17, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN11038027 FL Primary

Addresses

Primary practice location

621 W Lumsden Rd
Brandon, FL 33511-5911

Mailing address

114 Hampton Rd Apt 211
Clearwater, FL 33759-4110
Phone (405) 409-4991

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250325002940 FL Practitioner - Nurse Practitioner 7618490103 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11038027FLMDGerontology Nurse Practitioner

Practice roles (2 of 4)

OrganizationSpecialtyStatusNew patients
Sunshine Pulmonary and Sleep Medicine P.a. CurrentSince Mar 24, 2025 Accepting new patients
Heart Vascular and Vein of Tampa Bay LLC CurrentSince Apr 14, 2025 Accepting new patients

Locations

621 W Lumsden Rd
Brandon, FL 33511
Phone (813) 655-1100

10141 Big Bend Rd
Ste 201
Riverview, FL 33578
Phone (813) 684-3707

1901 Haverford Ave
Ste 111
Sun City Ctr, FL 33573
Phone (727) 231-0846

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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": "1742169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1922808286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 HAMPTON RD APT 211",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337594110",
            "telephone_number": "405-409-4991",
            "fax_number": "813-755-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 W LUMSDEN RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115911",
            "telephone_number": "813-755-3500",
            "fax_number": "813-755-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAIRAZAMAN",
        "first_name": "CARLOS",
        "middle_name": "TOD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-17",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11038027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.