NPIMap

Organization Active NPI

Palm Medical Center Lakeland LLC

  • General Practice Physician
  • Land O Lakes, FL
National Provider Identifier
1649124827
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
PALM MEDICAL CENTER LAKELAND LLC
Practice address
2416A Land O Lakes Blvd
Land O Lakes, FL 34639-4907
Phone
(813) 949-8822
Fax
(813) 949-1103
NPI assigned
Feb 24, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Authorized official

Name
Carmel N Boswell
Title
Credentialing Manager
Phone
(813) 538-7880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

2416A Land O Lakes Blvd
Land O Lakes, FL 34639-4907

Mailing address

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2041287Palm Medical Center2416 Land O Lakes Blvd Suite a, Land O Lakes, FL 34639Certificate of waiverMay 20, 2028

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

Locations

2416 Land O Lakes Blvd
#A
Land O Lakes, FL 34639
Phone (813) 909-4931

NPI Registry JSON

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

{
    "created_epoch": "1771891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771891200000",
    "number": "1649124827",
    "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": "2416A LAND O LAKES BLVD",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346394907",
            "telephone_number": "813-949-8822",
            "fax_number": "813-949-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM MEDICAL CENTER LAKELAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-24",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A",
        "authorized_official_last_name": "BOSWELL",
        "authorized_official_first_name": "CARMEL",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "813-538-7880"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Land O Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.