GLORIMAR GONZALEZ SAMOT (M.D.) – General Practice Physician, NPI 1700111614

GLORIMAR GONZALEZ SAMOT (M.D.) is a healthcare provider. based in Brandon, Florida. specializing in GENERAL PRACTICE. They hold the professional credentials M.D.. They hold a License No. 17491 (PR). The NPI Number for GLORIMAR GONZALEZ SAMOT (M.D.) is 1700111614

Main info

Female
Sole Proprietor
20 Years Of Experience
Accepts Medicare Assignment
Name
GLORIMAR GONZALEZ SAMOT (M.D.)
NPI
1700111614
Phone
(813) 588-5123
Address
675 S KINGS AVE STE 101
Enumeration Date
9 October 2009
Last Update Date
12 July 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8135885123
Graduation Year
2006 (20 years ago)
PAC ID
3274662291
Group Practice PAC ID
3971961079
Professional Enrollment ID
I20160812000468
Address ID
FL335116048BR675XXAVEX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness75
Years active:16State licenses:2Digital endpointsOther names

1,466 GENERAL PRACTICE in FL

Provider Addresses for GLORIMAR GONZALEZ SAMOT (M.D.)

  • 675 S KINGS AVE STE 101

    BRANDON, FL 335116048

    Phone: (813) 588-5123

    Fax: (863) 646-9664

    Type: Location

  • Bartow Road, Lakeland, Polk County, Florida, 33081, United States

    STE 101

    LAKELAND, FL 338124334

    Phone: (863) 646-9663

    Fax: (863) 646-9664

    Type: Mailing

  • PO BOX 5618

    LAKELAND, FL 338075618

    Phone: (813) 588-5123

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-08-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160812000468IGeneral PracticeFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33511)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3971961079View full group profile
NameSpecialtyState
Internal MedicineFL

Reviews

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Frequently asked questions

What number should I use to identify GLORIMAR GONZALEZ SAMOT (M.D.) for billing?
Administrative and clinical systems typically use NPI 1700111614 for GLORIMAR GONZALEZ SAMOT (M.D.).
Does the public listing show GLORIMAR GONZALEZ SAMOT (M.D.) as active?
GLORIMAR GONZALEZ SAMOT (M.D.)'s NPI record reflects an active status in NPPES.
How should patients interpret GLORIMAR GONZALEZ SAMOT (M.D.)'s specialty?
The extract shows General Practice Physician for GLORIMAR GONZALEZ SAMOT (M.D.). Clinical services aligned with this taxonomy classification.
Can patients visit GLORIMAR GONZALEZ SAMOT (M.D.) in Brandon, Florida?
For routing, start with Brandon, Florida for GLORIMAR GONZALEZ SAMOT (M.D.), then verify phone and hours locally.
Who maintains GLORIMAR GONZALEZ SAMOT (M.D.)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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