NPIMap

Organization Active NPI

Dedicated Senior Medical Centers of Florida, LLC

  • Non-Pharmacy Dispensing Site
  • Lakeland, FL
National Provider Identifier
1750090163
Registry record updated Apr 24, 2023
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
Practice address
105 S Florida Ave FL 3
Lakeland, FL 33801-4619
Phone
(863) 777-2443
Fax
(863) 614-1711
NPI assigned
Nov 15, 2022
Organization subpart
Yes
Parent organization
DEDICATED SENIOR MEDICAL CENTERS OF FLORIDA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Authorized official

Name
Mary Chen
Title
Authorized Official
Phone
(305) 628-6117

Specialties & licenses 1

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

Addresses

Primary practice location

105 S Florida Ave FL 3
Lakeland, FL 33801-4619

Mailing address

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

Other names 1

  • DEDICATED SENIOR MEDICAL CENTER WEST MEMORIAL (TC) 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

NPI Registry JSON

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1750090163",
    "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": "105 S FLORIDA AVE FL 3",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338014619",
            "telephone_number": "863-777-2443",
            "fax_number": "863-614-1711"
        }
    ],
    "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": "2022-11-15",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "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 WEST MEMORIAL (TC)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.