Individual provider Active NPI

Larnel P Sultan, D.O.

  • Family Medicine Physician
  • Land O Lakes, FL
National Provider Identifier
1457318628
Registry record updated Dec 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS8734 Issued in FL
Practice address
20615 Amberfield Dr
Suite 102
Land O Lakes, FL 34638-4301
Phone
(813) 949-2950
Fax
(813) 949-2924
NPI assigned
Apr 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS8734 FL Primary

Addresses

Primary practice location

20615 Amberfield Dr
Suite 102
Land O Lakes, FL 34638-4301

Mailing address

20615 Amberfield Dr
Ste 102
Land O Lakes, FL 34638-4387
Phone (813) 977-0733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050418000168 FL Practitioner - Family Practice 5799722161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellmed Medical Management of Florida IncGroup PAC ID 3971678558, 158 clinicians

Practice addresses (Care Compare)

2044 Trinity Oaks Blvd
Suite 220
Trinity, FL 34655-4406
Phone (727) 645-6900

2940 S US Hwy 1
Suite C11 Wellmed at Fort Pierce
Fort Pierce, FL 34982-8143
Phone (772) 466-6855

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Clearwater, FL, CCN 109687
  • Morton Plant Hospital Hospital, Clearwater, FL, CCN 100127
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
OS8734FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Management of Florida Inc Family Medicine CurrentSince Dec 1, 2018 Accepting new patients
Trillium Medical Group of Florida Past Accepting new patients

Locations

500 Vonderburg Dr
Ste 303E
Brandon, FL 33511
Phone (813) 681-5702

2940 S US Highway 1
Ste C11
Fort Pierce, FL 34982
Phone (407) 423-5178

20615 Amberfield Dr
Ste 102
Land O Lakes, FL 34638
Phone (813) 949-2950

2044 Trinity Oaks Blvd
Ste 220
Trinity, FL 34655
Phone (727) 645-6900

2044 Trinity Oaks Blvd
Trinity, FL 34655
Phone (727) 645-6900

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: larnel.sultan@wellmed.eclinicaldirectplus.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1457318628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20615 AMBERFIELD DR",
            "address_2": "STE 102",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346384387",
            "telephone_number": "813-977-0733",
            "fax_number": "813-971-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20615 AMBERFIELD DR",
            "address_2": "SUITE 102",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346384301",
            "telephone_number": "813-949-2950",
            "fax_number": "813-949-2924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULTAN",
        "first_name": "LARNEL",
        "middle_name": "P",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-29",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS8734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Land O Lakes, FL

Sources for this page

Verify at the official NPI Registry.