Srinivas Samak MD.PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

28681 Issued in FL

Legal business name

SRINIVAS SAMAK MD.PA

Practice address

1500 Lakeland Hills Blvd
#4
Lakeland, FL 33805-3257

Phone

(863) 688-3674

Fax

(863) 616-9902

NPI assigned

Nov 15, 2007

Organization subpart

Yes

Parent organization

SRINIVAS P.SAMAK.MD.PA.As reported in NPPES

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

Authorized official

Name

Dr. Srinivas P Samak, MD

Title

President

Phone

(863) 688-3674

Specialties & licenses 1

Addresses

Other names 1

• SRINIVAS P.SAMAK.MD.PA. Former legal business name

Part of

Srinivas P Samak MD PA

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1265613509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 LAKELAND HILLS BLVD",
            "address_2": "#4",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053257",
            "telephone_number": "863-688-3674",
            "fax_number": "863-616-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 LAKELAND HILLS BLVD",
            "address_2": "#4",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053257",
            "telephone_number": "863-688-3674",
            "fax_number": "863-616-9902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRINIVAS SAMAK MD.PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SRINIVAS P.SAMAK.MD.PA.",
        "enumeration_date": "2007-11-15",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "SAMAK",
        "authorized_official_first_name": "SRINIVAS",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-688-3674",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "28681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SRINIVAS P.SAMAK.MD.PA.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Internal Medicine Physician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.