Provider Demographics
NPI:1902816259
Name:GARCIA - MACHADO, GUMERSINDO ROLANDO (MD)
Entity Type:Individual
Prefix:DR
First Name:GUMERSINDO
Middle Name:ROLANDO
Last Name:GARCIA - MACHADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7015 N ARMENIA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-5252
Mailing Address - Country:US
Mailing Address - Phone:813-488-9000
Mailing Address - Fax:813-488-9008
Practice Address - Street 1:7015 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-5252
Practice Address - Country:US
Practice Address - Phone:813-488-9000
Practice Address - Fax:813-488-9008
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13350208D00000X
FLACN243208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRAMERICAN HEALTH 1701OtherHEALTH INSURANCE
PRMMMOtherHEALTH INSURANCE
PAHUMANA 646-0013OtherHEALTH INSURANCE
PRACA 01-2204-4OtherINSURANCE
PRGOBAL HEALTH PLANOtherHEA;TJ INSURANCE
PAUTI 201447OtherHEALTH INSURANCE
PA13350OtherSTATE MEDICAL LICENSE
PRMCSOtherHEALTH INSURANCE
PRTRIPLE-SOtherHEALT INSURANCE
PRH-35855Medicare UPIN
PAHUMANA 646-0013OtherHEALTH INSURANCE