NPIMap

Organization Active NPI

Davita Medical Florida, Inc.

Doing business as DaVita Medical Group

  • Non-Pharmacy Dispensing Site
  • Bradenton, FL
National Provider Identifier
1508233537
Registry record updated Jul 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
ME116650 Issued in FL
Legal business name
DAVITA MEDICAL FLORIDA, INC.
Doing business as
DaVita Medical Group
Practice address
2424 Manatee Ave W
Suite 100
Bradenton, FL 34205-4954
Phone
(941) 847-7920
NPI assigned
Aug 25, 2015
Last updated
Jul 21, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2017

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

Authorized official

Name
Lauren Edgington
Title
Cfo
Phone
(727) 286-4065

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X ME116650 FL Primary

Addresses

Primary practice location

2424 Manatee Ave W
Suite 100
Bradenton, FL 34205-4954

Mailing address

10051 5TH Street N.
St. Petersburg, FL 33702

Other names 1

  • DaVita Medical Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Davita Medical Group13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

2424 Manatee Ave W
Ste 100
Bradenton, FL 34205
Phone (941) 847-7290

NPI Registry JSON

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

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500595200000",
    "number": "1508233537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10051 5TH STREET N.",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "33702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 MANATEE AVE W",
            "address_2": "SUITE 100",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342054954",
            "telephone_number": "941-847-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVITA MEDICAL FLORIDA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-25",
        "last_updated": "2017-07-21",
        "status": "A",
        "authorized_official_last_name": "EDGINGTON",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "727-286-4065"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "FL",
            "license": "ME116650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DaVita Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.