Organization Active NPI

Verimed Health Group Land O' Lakes, LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Land O' Lakes, FL
National Provider Identifier
1154781284
Registry record updated Mar 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
VERIMED HEALTH GROUP LAND O' LAKES, LLC
Practice address
2638 Narnia Way
Ste 101
Land O Lakes, FL 34638-7231
Phone
(813) 909-0760
Fax
(813) 949-7394
NPI assigned
Mar 2, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2016

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

Authorized official

Name
Miss Gina Perez, ADM
Title
Administrator
Phone
(813) 909-0760

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

2638 Narnia Way
Ste 101
Land O Lakes, FL 34638-7231

Mailing address

2638 Narnia Way
Ste 101
Land O Lakes, FL 34638-7231
Phone (813) 909-0760

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170202002751 FL Part B Supplier - Clinic/Group Practice 4082997796 Receives reassigned benefits from 4 practitioners
Practice locations: Land O Lakes, FL

National Provider Directory

National Provider Directory

Locations

2638 Narnia Way
Unit 101
Land O Lakes, FL 34638
Phone (813) 528-8000

2674 Stonewood Park Loop
Land O Lakes, FL 34638
Phone (813) 909-0760

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1456876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456876800000",
    "number": "1154781284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2638 NARNIA WAY",
            "address_2": "STE 101",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346387231",
            "telephone_number": "813-909-0760",
            "fax_number": "813-949-7394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2638 NARNIA WAY",
            "address_2": "STE 101",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346387231",
            "telephone_number": "813-909-0760",
            "fax_number": "813-949-7394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERIMED HEALTH GROUP LAND O' LAKES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-02",
        "last_updated": "2016-03-02",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "813-909-0760",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "ADM"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Land O' Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.