Davita Medical Florida, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH20947 Issued in FL

Legal business name

DAVITA MEDICAL FLORIDA, INC.

Practice address

11920 Seminole Blvd
Largo, FL 33778-2803

Phone

(727) 828-0378

Fax

(727) 828-0390

NPI assigned

Dec 11, 2006

Organization subpart

No

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

Authorized official

Name

James Hilger

Title

Chief Accounting Officer

Phone

(253) 973-0777

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• DaVita Medical Group, Pharmacy Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Intermountain Medical Holdings Nevada Inc

  • Internal Medicine Physician
  • Henderson, NV
  • NPI 1245997279

  Member Of

  NPD member

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Optumcare Florida Ci, LLC

  • Primary Care Clinic/Center
  • Winter Park, FL
  • NPI 1720506603

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494374400000",
    "number": "1073673208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10051 5TH STREET NORTH",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "337022299",
            "telephone_number": "727-828-0378",
            "fax_number": "727-828-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11920 SEMINOLE BLVD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337782803",
            "telephone_number": "727-828-0378",
            "fax_number": "727-828-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVITA MEDICAL FLORIDA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2017-05-10",
        "status": "A",
        "authorized_official_last_name": "HILGER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-973-0777"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH20947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028343600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2003983",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DaVita Medical Group, Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Lynn Davis, M.S., CCCSLP
• McKenzie L Davis
• Pashion Davis
• Saniya Davis
• Stephanie Davis, APRN
• Daphne D Days
• Megan Elizabeth De la Portilla, LCSW
• Alexsandra De Oliveira, ARNP
• Kimberly A Dean, DO
• Desiree Deangelo

• Community/Retail Pharmacy in Largo, FL
• Providers in Largo, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; 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.