La Vida Medical Group , Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LA VIDA MEDICAL GROUP , INC

Practice address

3802 Gunn Hwy
Tampa, FL 33618-8793

Phone

(813) 296-6266

Fax

(813) 522-8929

NPI assigned

Jan 14, 2025

Last updated

Jan 14, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

LA VIDA MEDICAL GROUP INCAs reported in NPPES

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

Authorized official

Name

Sanlly Perez Ceballos, MDNPI 1356728067

Title

President

Phone

(813) 296-6266

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• La Vida Medical Group , Inc

  • Internal Medicine Physician
  • Oldsmar, FL
  • NPI 1982377065

  O20211012003000

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

La Vida Medical Group Inc2 organizations share this tax ID, including this one

Part of

La Vida Medical Group Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• La Vida Medical Group , Inc

  • Internal Medicine Physician
  • Oldsmar, FL
  • NPI 1982377065
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• La Vida Medical Group , Inc

  • Internal Medicine Physician
  • Oldsmar, FL
  • NPI 1982377065
  NPPES parent name

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sanlly Perez Ceballos, M.D.

  • Internal Medicine Physician
  • Tampa, FL
  • NPI 1356728067
  NPD Authorized official
• Francisco Tomas Fernandez Rodriguez, M.D.

  • Internal Medicine Physician
  • Tampa, FL
  • NPI 1679985956
  NPD
• Mayelin Perez Reina, NP

  • Family Nurse Practitioner
  • St Petersburg, FL
  • NPI 1831909985
  NPD

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

{
    "created_epoch": "1736812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1437960077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3802 GUNN HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336188793",
            "telephone_number": "813-296-6266",
            "fax_number": "813-522-8929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 GUNN HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336188793",
            "telephone_number": "813-296-6266",
            "fax_number": "813-522-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA VIDA MEDICAL GROUP , INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LA VIDA MEDICAL GROUP INC",
        "enumeration_date": "2025-01-14",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A",
        "authorized_official_last_name": "PEREZ CEBALLOS",
        "authorized_official_first_name": "SANLLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-296-6266",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• La Rosa Alf Corp
• La Rosa Home Health LLC
• Nikki La Rosa, PHD
• Sheryl La Rue
• La Vida En El Mar Alf
• Ai Ai La
• Kiet Tuan La, MD
• Lab-Athena, Inc
• Danny Rafik Lababidi, MD
• Marie E. Labadie-Degennaro, APRN

• Internal Medicine Physician in Tampa, FL
• Providers in Tampa, 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 Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.