Davita Medical Florida, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH13061 Issued in FL

Legal business name

DAVITA MEDICAL FLORIDA, INC.

Doing business as

DaVita Medical Group, Pharmacy

Practice address

1931 W Lumsden Rd
Brandon, FL 33511-8819

Phone

(813) 681-7888

Fax

(813) 661-0843

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 3

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

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": "1336209568",
    "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": "813-681-7888",
            "fax_number": "813-661-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 W LUMSDEN RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335118819",
            "telephone_number": "813-681-7888",
            "fax_number": "813-661-0843"
        }
    ],
    "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": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH13061",
            "primary": true
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030848000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2013026",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4399230004",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DaVita Medical Group, Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shantoria Davis
• Tammy Davis
• Thomas M Davison, MD
• William A. Davison, M.D.
• William John Davison, PA-C
• Annabella Day
• Marissa Day
• Rebecca A Daye
• DBT Counseling Specialties LLC
• Jose Perez Gonzalez De Apodaca, M.D./PH.D

• Community/Retail Pharmacy in Brandon, FL
• Providers in Brandon, 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.