Individual provider Active NPI

Ansley Lorch Dafnis, MD

  • Family Medicine Physician
  • Valrico, FL
National Provider Identifier
1609227586
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME138583 Issued in FL
Practice address
3301 Anna George Dr
Valrico, FL 33596-6435
Phone
(813) 431-5052
Fax
(813) 308-1460
NPI assigned
Jun 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TRN22956 FL
Family Medicine Physician 207Q00000X ME138583 FL Primary

Addresses

Primary practice location

3301 Anna George Dr
Valrico, FL 33596-6435

Mailing address

3301 Anna George Dr
Valrico, FL 33596-6435

Other identifiers 1

IdentifierTypeStateIssuer
103583600MedicaidFL

Other names 1

  • Dr. Ansley Hadden Lorch Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 1, 2022 through Jan 1, 2028

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Radley L Griffin MD PL CurrentSince Oct 1, 2021 Accepting new patients
Lake Shore Hma, LLC PastSince Oct 1, 2021 Accepting new patients

Locations

2420 W Mississippi Ave
Tampa, FL 33629
Phone (813) 350-9090

1315 S Howard Ave
Ste 102
Tampa, FL 33606
Phone (813) 350-9090

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.

NPI Registry JSON

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1609227586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 ANNA GEORGE DR",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335966435",
            "fax_number": "813-308-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 ANNA GEORGE DR",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335966435",
            "telephone_number": "813-431-5052",
            "fax_number": "813-308-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAFNIS",
        "first_name": "ANSLEY",
        "middle_name": "LORCH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-22",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "TRN22956",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME138583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103583600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANSLEY",
            "last_name": "LORCH",
            "middle_name": "HADDEN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Valrico, FL

Sources for this page

Verify at the official NPI Registry.