Beacon Medical Center of Lakeland, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

BEACON MEDICAL CENTER OF LAKELAND, LLC

Practice address

2419 US Highway 98 N
Lakeland, FL 33805

Phone

(863) 333-0741

NPI assigned

Jul 10, 2026

Organization subpart

No

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

Authorized official

Name

Octavio A Bravo

Title

Owner

Phone

(305) 905-1399

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1783641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783641600000",
    "number": "1790604262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2419 US HIGHWAY 98 N",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33805",
            "telephone_number": "863-333-0741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2419 US HIGHWAY 98 N",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33805",
            "telephone_number": "863-333-0741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON MEDICAL CENTER OF LAKELAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-10",
        "last_updated": "2026-07-10",
        "certification_date": "2026-06-18",
        "status": "A",
        "authorized_official_last_name": "BRAVO",
        "authorized_official_first_name": "OCTAVIO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-905-1399"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Bazini, LMHC
• John A Bazley, MD
• Robert D. Bazley, M.D.
• BCH Support LLC
• Caitlyn Beacham, ARNP
• Andrea Beale, A.R.N.P.
• Nikki Darlene Beales, MSN, APRN, FNP-C
• Ashley Bearden
• Joseph H Beardsley, AP-DOM
• Grecia Beascoechea

• Primary Care Clinic/Center in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; 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.