Luis C Favilli MD LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME0056610 Issued in FL

Legal business name

LUIS C FAVILLI MD LLC

Doing business as

FAVILLI FAMILY PRACTICE CENTER

Practice address

3650 Innovation Dr
Lakeland, FL 33812-4105

Phone

(863) 646-6295

Fax

(863) 701-2151

NPI assigned

Nov 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Luis C Favilli, MD

Title

Family Practice

Phone

(863) 285-7171

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• FAVILLI FAMILY PRACTICE CENTER Doing business as

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493251200000",
    "number": "1336321835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6675 WESTWOOD BLVD",
            "address_2": "STE 475",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328218061",
            "telephone_number": "407-845-0330",
            "fax_number": "888-972-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 INNOVATION DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338124105",
            "telephone_number": "863-646-6295",
            "fax_number": "863-701-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUIS C FAVILLI MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-27",
        "last_updated": "2017-04-27",
        "status": "A",
        "authorized_official_last_name": "FAVILLI",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "FAMILY PRACTICE",
        "authorized_official_telephone_number": "863-285-7171",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0056610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "E49325",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAVILLI FAMILY PRACTICE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Doreen Opal Lue
• Luis Daniel Lugo Rosado, M.D.
• Ernie Tairon Lugo
• Jose Lugo, DO
• Luis Alberto Lugo Jr., LMT
• Jeswin Lukose, RPH
• Lumikids Ppec LLC
• Lumina Dental of Lakeland,PA
• Fadette Lumorin, FNP-BC
• Graciela Margarita Luna, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.