Opulent Medical Care LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

OPULENT MEDICAL CARE LLC

Practice address

211 E Main St # 435
Lakeland, FL 33801-4628

Phone

(863) 944-6977

NPI assigned

Mar 27, 2025

Last updated

Mar 27, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alicia Self, DNPNPI 1154885804

Title

Ceo

Phone

(863) 944-6977

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Alicia Self, DNP-FNP-C

  • Family Nurse Practitioner
  • Lakeland, FL
  • NPI 1154885804
  NPD Authorized official

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

{
    "created_epoch": "1743033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743033600000",
    "number": "1457154379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E MAIN ST # 435",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338014628",
            "telephone_number": "863-944-6977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E MAIN ST # 435",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338014628",
            "telephone_number": "863-944-6977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPULENT MEDICAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-27",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A",
        "authorized_official_last_name": "SELF",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "863-944-6977",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; 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.