NPIMap

Organization Active NPI

Palm Medical Center Lakeland LLC

  • Primary Care Clinic/Center
  • Clermont, FL
National Provider Identifier
1649048281
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PALM MEDICAL CENTER LAKELAND LLC
Practice address
16215 Sr 50 Ste 102
Clermont, FL 34711-6019
Phone
(352) 221-9136
Fax
(352) 221-9146
NPI assigned
Dec 13, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Authorized official

Name
Santiago Moises Martin
Title
President Center Operations
Phone
(305) 913-9441

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

16215 Sr 50 Ste 102
Clermont, FL 34711-6019

Mailing address

2600 S Douglas Rd Ste 308
Coral Gables, FL 33134-6134
Phone (305) 913-9454

National Provider Directory

National Provider Directory
Tax ID family
Palm Medical Center Lakelan36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1702425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702425600000",
    "number": "1649048281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 S DOUGLAS RD STE 308",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331346134",
            "telephone_number": "305-913-9454",
            "fax_number": "305-442-1198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16215 SR 50 STE 102",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116019",
            "telephone_number": "352-221-9136",
            "fax_number": "352-221-9146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM MEDICAL CENTER LAKELAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-13",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A",
        "authorized_official_last_name": "MOISES MARTIN",
        "authorized_official_first_name": "SANTIAGO",
        "authorized_official_title_or_position": "PRESIDENT CENTER OPERATIONS",
        "authorized_official_telephone_number": "305-913-9441"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; 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.