NPIMap

Organization Active NPI

Dedicated Senior Medical Centers of Florida, LLC

Doing business as Dedicated Senior Medical Center Lealman

  • Non-Pharmacy Dispensing Site
  • St Petersburg, FL
National Provider Identifier
1710649769
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
DEDICATED SENIOR MEDICAL CENTERS OF FLORIDA, LLC
Doing business as
Dedicated Senior Medical Center Lealman
Practice address
2805 54TH Ave N Ste 500
St Petersburg, FL 33714-2414
Phone
(727) 341-5800
Fax
(727) 341-5307
NPI assigned
Oct 7, 2021
Last updated
Oct 7, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
DEDICATED SENIOR MEDICAL CENTERS OF FLORIDA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Authorized official

Name
Mary Chen
Title
Executive Officer
Phone
(305) 628-6117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

2805 54TH Ave N Ste 500
St Petersburg, FL 33714-2414

Mailing address

1395 NW 167TH St
Miami Gardens, FL 33169-5710
Phone (305) 628-6117

Other names 1

  • Dedicated Senior Medical Center Lealman Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dedicated Senior Medical Center of Florida LLC28 organizations share this tax ID, including this one
Part of
Dedicated Senior Medical Center of Florida LLC

Other organizations with this tax ID 27

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

View all 27

Locations

2805 54th Ave N
Ste 500
St Petersburg, FL 33714
Phone (727) 341-5800

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633564800000",
    "number": "1710649769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "305-628-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 54TH AVE N STE 500",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337142414",
            "telephone_number": "727-341-5800",
            "fax_number": "727-341-5307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEDICATED SENIOR MEDICAL CENTERS OF FLORIDA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEDICATED SENIOR MEDICAL CENTERS OF FLORIDA, LLC",
        "enumeration_date": "2021-10-07",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "305-628-6117"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dedicated Senior Medical Center Lealman",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; 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.