NPIMap

Individual provider Active NPI

Fernando Loret de Mola, MD

  • Family Medicine Physician
  • Lakeland, FL
National Provider Identifier
1528031960
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME69274 Issued in FL
Practice address
3030 Harden Blvd
Lakeland, FL 33803-7952
Phone
(863) 284-1700
NPI assigned
Feb 8, 2006
Last updated
Aug 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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 ME69274 FL Primary

Addresses

Primary practice location

3030 Harden Blvd
Lakeland, FL 33803-7952

Mailing address

3175 Highlands by the Lake Way
Lakeland, FL 33812-5048

Other practice location 1

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019
Phone (863) 680-7000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100114000730 FL Practitioner - Family Practice 1951376169 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Watson Clinic LLPGroup PAC ID 1456258979, 365 clinicians

Practice addresses (Care Compare)

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019
Phone (863) 680-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.18 of 100Reported as apm
Quality
70.68
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue466
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME69274FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Watson Clinic LLP Family Medicine CurrentSince Feb 1, 1996 Accepting new patients
Watson Clinic LLP Past Accepting new patients

Locations

1430 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 680-7337

3030 Harden Blvd
Lakeland, FL 33803
Phone (863) 687-1222

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

1600 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 680-7190

Organizations & group practices 3

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

Hospital & facility affiliations 7

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1528031960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3175 HIGHLANDS BY THE LAKE WAY",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338125048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 HARDEN BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338037952",
            "telephone_number": "863-284-1700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Lakeland Hills Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338053019",
            "country_code": "US",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LORET DE MOLA",
        "first_name": "FERNANDO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME69274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.