Organization Active NPI

Gastro MD Anesthesia, LLC

  • Anesthesiology Physician
  • Tampa, FL
National Provider Identifier
1952989758
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
GASTRO MD ANESTHESIA, LLC
Practice address
5016 W Cypress St Ste 100
Tampa, FL 33607-3804
Phone
(813) 542-2586
Fax
(813) 281-1735
NPI assigned
Apr 1, 2021
Organization subpart
Yes
Parent organization
GASTRO MD, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Authorized official

Name
Charles M. Davis
Title
Chief Operating Offier
Phone
(813) 477-5580

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

5016 W Cypress St Ste 100
Tampa, FL 33607-3804

Mailing address

511 W Bay St Ste 400
Tampa, FL 33606-2700
Phone (813) 819-0309

National Provider Directory

National Provider Directory

Locations

2863 Wellness Ave
Orange City, FL 32763
Phone (286) 297-7239

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617235200000",
    "number": "1952989758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 W BAY ST STE 400",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062700",
            "telephone_number": "813-819-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5016 W CYPRESS ST STE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336073804",
            "telephone_number": "813-542-2586",
            "fax_number": "813-281-1735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTRO MD ANESTHESIA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GASTRO MD, LLC",
        "enumeration_date": "2021-04-01",
        "last_updated": "2021-04-01",
        "certification_date": "2021-03-31",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFIER",
        "authorized_official_telephone_number": "813-477-5580"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "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 Apr 1, 2021; 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.