OPTUMCARE FLORIDA, LLC (NPI# 1023402088) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023402088 |
| Entity Type | Organization |
| Organization Name | OPTUMCARE FLORIDA, LLC |
| Other Organization Name | DAVITA MEDICAL GROUP |
| Practice Address |
770 W Dr Martin Luther King Jr Blvd Seffner FL 33584-4534 |
| Mailing Address |
10051 5th St. North Saint Petersburg FL 33702 |
| Practice Telephone | 8136547005 |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2019-08-19 |
| Authorized Official Name | JOHN G. LIETHEN (SECRETARY) |
| Authorized Official Telephone | 9522056262 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | OS8544 | FL | Suppliers |
| Other Name | Type Code |
|---|---|
| DaVita Medical Group | Doing Business As Name - Organization |
| JSA Medical Group-Seffner | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659749943 | Optumcare Florida, LLC | Non-Pharmacy Dispensing Site | 406 W Bloomingdale Ave, Brandon, FL 33511-7402 | 2015-09-03 |
| 1558681460 | Optumcare Florida, LLC | Pharmacy | 4757 Us Highway 19 Ste A, New Port Richey, FL 34652-4945 | 2010-06-03 |
| 1245390475 | Optumcare Florida, LLC | Pharmacy | 3665 W Waters Ave, Tampa, FL 33614-2783 | 2006-12-11 |
| 1063572295 | Optumcare Florida, LLC | Pharmacy | 4757 Us Highway 19, New Port Richey, FL 34652-4945 | 2006-12-11 |
| 1659884294 | Optumcare Florida, LLC | Hospitalist | 10051 5th St N Ste 200, St Petersburg, FL 33702-2211 | 2017-11-06 |
| 1558739847 | Optumcare Florida, LLC | Non-Pharmacy Dispensing Site | 1933 W Lumsden Rd, Brandon, FL 33511-8819 | 2015-09-03 |
| 1780051714 | Optumcare Florida, LLC | Non-Pharmacy Dispensing Site | 931 10th St E, Palmetto, FL 34221-4131 | 2015-08-25 |
| 1043687072 | Optumcare Florida, LLC | Non-Pharmacy Dispensing Site | 2727 W Dr Mlk Blvd, Suite 850, Tampa, FL 33607-6383 | 2015-08-25 |
| 1912374943 | Optumcare Florida, LLC | Non-Pharmacy Dispensing Site | 7240 W Colonial Dr, Orlando, FL 32818-6749 | 2015-08-25 |
| 1356737399 | Optumcare Florida, LLC | Non-Pharmacy Dispensing Site | 3675 W Waters Ave, Tampa, FL 33614-2783 | 2015-04-07 |
| Street Address |
770 W DR MARTIN LUTHER KING JR BLVD |
| City | SEFFNER |
| State | FL |
| Zip Code | 33584-4534 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043206816 | Michael Anthony Zane | Internal Medicine | 770 W Dr Martin Luther King Jr Blvd, Seffner, FL 33584-4534 | 2005-09-27 |
| 1720454259 | Meera Ghayal | Family Medicine | 770 W Dr Martin Luther King Jr Blvd, Seffner, FL 33584-4534 | 2015-08-19 |
| 1811231749 | Gabrielle Beth Frankenfield | Nurse Practitioner | 770 W Dr Martin Luther King Jr Blvd, Seffner, FL 33584-4534 | 2012-11-15 |
| 1316064504 | Trice Lininger | Nurse Practitioner | 770 W Dr Martin Luther King Jr Blvd, Seffner, FL 33584-4534 | 2007-03-23 |
| 1932163961 | Jose Luis Soler | Internal Medicine | 770 W Dr Martin Luther King Jr Blvd, Seffner, FL 33584-4534 | 2006-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821555442 | Dipal Surendra Desai | Pharmacist | 11720 Dr Martin Luther King Boulevard, Seffner, FL 33584 | 2019-03-01 |
| 1508395997 | Patricia R Philbert | Clinic/Center | 311 Carriage Oak Place, Seffner, FL 33584 | 2017-06-08 |
| 1225584824 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 11782 E Dr. Mlk Jr. Blvd, Seffner, FL 33584 | 2016-09-01 |
| 1023564903 | Georges Raffoul | Dentist | 2744 South Florida Ave, Lakeland, FL 33584 | 2016-08-30 |
| 1407302771 | Ashari Taylor | Physical Therapy Assistant | 11754 E Dr Mlk Jr Blvd, Seffner, FL 33584 | 2016-08-28 |
| 1235547043 | Foot & Ankle of Tampa Bay, Pllc | Podiatrist | 2204 S. Parson Ave, Seffner, FL 33584 | 2014-07-24 |
| 1205108990 | Brenda Thuy Dang-nguyen | Pharmacist | 11115 E Dr Mlk Jr Blvd, Seffner, FL 33584 | 2012-01-27 |
| 1205106895 | Joy Aclan | Pharmacist | 11115 E Dr. Martin Luther King Jr Blvd, Seffner, FL 33584 | 2012-01-12 |
| 1366748659 | Sarah Marilyn Ball | Massage Therapist | 2027 S. Parsons Ave., Seffner, FL 33584 | 2011-02-03 |
| 1386814366 | Total Orthopedic Rehabilitation, Inc | Chiropractor | 1115 Dr Martin Luther King Junior Blvd, Seffner, FL 33584 | 2008-03-06 |
| Find all providers in zip 33584 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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| 1437765823 | South Miami Hospital, Inc | Non-Pharmacy Dispensing Site | 1228 S Pine Island Rd Ste 110, Plantation, FL 33324-4402 | 2020-09-21 |
| 1407460223 | Daisy Lomadilla Boyer | Non-Pharmacy Dispensing Site | 11703 Holly Creek Dr, Riverview, FL 33569-3356 | 2020-08-31 |
| 1760091078 | West Kendall Baptist Hospital, Inc. | Non-Pharmacy Dispensing Site | 14591 Sw 26th St, Miami, FL 33175-8038 | 2020-07-23 |
| 1821615436 | South Miami Hospital, Inc | Non-Pharmacy Dispensing Site | 8400 Nw 53rd St Ste F106, Doral, FL 33166-4519 | 2020-06-30 |
| 1295358422 | Ezze Pharma LLC | Non-Pharmacy Dispensing Site | 3105 Nw 107th Ave Ste 400, Doral, FL 33172-2215 | 2020-05-21 |
| 1871115436 | Kempcare Inc. | Non-Pharmacy Dispensing Site | 840 Us Highway 1 Ste 435c, N Palm Beach, FL 33408-3829 | 2020-05-17 |
| 1427670595 | Orlando Dermatology Clinic, LLC | Non-Pharmacy Dispensing Site | 3261 Us Highway 441/27 Ste F1, Fruitland Park, FL 34731-4495 | 2020-05-12 |
| 1518593177 | Dedicated Senior Medical Center of Florida, LLC | Non-Pharmacy Dispensing Site | 2724 N Hiawassee Rd Ste 100, Orlando, FL 32818-3008 | 2020-03-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.