Active NPI
Srinivas P Samak, MD
- Internal Medicine Physician
- Lakeland, FL
National Provider Identifier
1669465969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME0028681
- Practice address
- 1500 Lakeland Hills Blvd
Ste 4
Lakeland, FL 33805-3257 - Phone
- (863) 688-3674
- Fax
- (863) 616-9902
- NPI assigned
- Aug 23, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME0028681 | FL | Primary |
Addresses
Primary practice location
1500 Lakeland Hills Blvd
Ste 4
Lakeland, FL 33805-3257
Mailing address
1500 Lakeland Hills Blvd
Ste 4
Lakeland, FL 33805-3257
Phone (863) 688-3674
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0028681 | FL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669465969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 LAKELAND HILLS BLVD",
"address_2": "STE 4",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338053257",
"telephone_number": "863-688-3674",
"fax_number": "863-616-9902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 LAKELAND HILLS BLVD",
"address_2": "STE 4",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338053257",
"telephone_number": "863-688-3674",
"fax_number": "863-616-9902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMAK",
"first_name": "SRINIVAS",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME0028681",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
- Saltzman, Tanis, Pittell, Levin and Jacobson, LLC (Pediatric Associates)
- Robert Salzman, APRN, FNP-C
- Sam's Club Optical
- Sam's Club Optical (Sam's Club Optical 30-6441)
- Jay K Samak, PA-C
- Yvette Samara, AUD
- Edwin Ashton Sammer, M.D.
- Sams East Inc (Sams Pharmacy 10-6441)
- Sams East Inc (Sams Pharmacy 10-4794)
- Franeisy Sanabria Arteaga, RBT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.