Organization Active NPI

Advanced Internal Medicine Care, PA

  • Internal Medicine Physician
  • Lakeland, FL
National Provider Identifier
1811130339
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ADVANCED INTERNAL MEDICINE CARE, PA
Practice address
5455 S Florida Ave
Lakeland, FL 33813-2523
Phone
(863) 644-3585
Fax
(863) 644-3171
NPI assigned
Apr 14, 2009
Last updated
Jan 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Authorized official

Name
Dr. Dario Fernando Cardona, M.DNPI 1770787434
Title
Internal Medicine
Phone
(863) 644-3585

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 9970043900 FL
Internal Medicine Physician 207R00000X NU Primary
General Practice Physician 208D00000X NU

Addresses

Primary practice location

5455 S Florida Ave
Lakeland, FL 33813-2523

Mailing address

5425 S Florida Ave
Lakeland, FL 33813-2523
Phone (863) 644-3585

Other practice location 1

203 Kingsway Rd
Brandon, FL 33510-4679
Phone (813) 819-7780

Other practice location 2

5245 US Highway 98 N
Lakeland, FL 33809-0516
Phone (863) 606-1616

Other practice location 3

134 Ariana Ave
Auburndale, FL 33823-3355
Phone (863) 662-4677

Other practice location 4

1045 E County Road 540A
Lakeland, FL 33813-3735
Phone (863) 940-9990

Other identifiers 1

IdentifierTypeStateIssuer
000487200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090723000176 FL Part B Supplier - Clinic/Group Practice 2466504386 Receives reassigned benefits from 17 practitioners
Practice locations: Lakeland, FL; Brandon, FL; Auburndale, FL

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
10D2101038Advanced Internal Medicine Care PA5245 US Hwy 98 N, Lakeland, FL 33809Certificate of waiverAug 25, 2027
10D2142473Advanced Internal Medicine Care, PA134 Ariana Ave, Auburndale, FL 33823Certificate of waiverJan 10, 2028
10D2262112Advanced Internal Medicine Care, PA203 Kingsway Rd, Brandon, FL 33510Certificate of waiverJun 8, 2028
10D2299327Advanced Internal Medicine Care, PA5455 S Florida Ave, Lakeland, FL 33813Certificate of waiverFeb 18, 2028

National Provider Directory

National Provider Directory

Locations

203 Kingsway Rd
Brandon, FL 33510
Phone (813) 685-8085

1045 State Road 540A
Lakeland, FL 33813
Phone (863) 607-9600

5245 US Highway 98 N
Lakeland, FL 33809
Phone (863) 606-1616

5422 Strickland Ave
Lakeland, FL 33812
Phone (863) 644-3585

5425 S Florida Ave
Lakeland, FL 33813
Phone (863) 644-3585

5455 S Florida Ave
Lakeland, FL 33813
Phone (863) 644-3585

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1239667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704412800000",
    "number": "1811130339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132523",
            "telephone_number": "863-644-3585",
            "fax_number": "863-644-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132523",
            "telephone_number": "863-644-3585",
            "fax_number": "863-644-3171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "203 Kingsway Rd",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335104679",
            "country_code": "US",
            "telephone_number": "813-819-7780",
            "fax_number": "863-644-3171",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5245 US Highway 98 N",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338090516",
            "country_code": "US",
            "telephone_number": "863-606-1616",
            "fax_number": "863-644-3171",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "134 Ariana Ave",
            "address_purpose": "LOCATION",
            "city": "Auburndale",
            "state": "FL",
            "postal_code": "338233355",
            "country_code": "US",
            "telephone_number": "863-662-4677",
            "fax_number": "863-644-3171",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1045 E County Road 540A",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338133735",
            "country_code": "US",
            "telephone_number": "863-940-9990",
            "fax_number": "863-644-3171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED INTERNAL MEDICINE CARE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-14",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A",
        "authorized_official_last_name": "CARDONA",
        "authorized_official_first_name": "DARIO",
        "authorized_official_middle_name": "FERNANDO",
        "authorized_official_title_or_position": "INTERNAL MEDICINE",
        "authorized_official_telephone_number": "863-644-3585",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "9970043900",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000487200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jan 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.