NPIMap

Organization Active NPI

Palm Medical Center Lakeland LLC

  • Clinic/Center
  • Orlando, FL
National Provider Identifier
1457046757
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PALM MEDICAL CENTER LAKELAND LLC
Practice address
733 S Goldenrod Rd
Orlando, FL 32822-8100
Phone
(407) 664-0515
Fax
(407) 636-2591
NPI assigned
Apr 11, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Authorized official

Name
Santiago Moises Martin
Title
President Center Operations
Phone
(305) 913-9441

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

733 S Goldenrod Rd
Orlando, FL 32822-8100

Mailing address

733 S Goldenrod Rd
Orlando, FL 32822-8100
Phone (407) 664-0515

Other names 1

  • Palm Medical Centers Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Palm Medical Center Lakelan36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

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

View all 35

Locations

733 S Goldenrod Rd
Orlando, FL 32822
Phone (407) 664-0515

NPI Registry JSON

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681171200000",
    "number": "1457046757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 S GOLDENROD RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328228100",
            "telephone_number": "407-664-0515",
            "fax_number": "407-636-2591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 S GOLDENROD RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328228100",
            "telephone_number": "407-664-0515",
            "fax_number": "407-636-2591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM MEDICAL CENTER LAKELAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-11",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A",
        "authorized_official_last_name": "MOISES MARTIN",
        "authorized_official_first_name": "SANTIAGO",
        "authorized_official_title_or_position": "PRESIDENT CENTER OPERATIONS",
        "authorized_official_telephone_number": "305-913-9441"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palm Medical Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.