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DAVITA MEDICAL GROUP
NPI 1023402088
Non-Pharmacy Dispensing Site in Seffner, FL

Active since March 26, 2015CLIA Certified · 3 labs
770 W DR MARTIN LUTHER KING JR BLVD, SEFFNER, FL 33584(813) 654-7005 Get Directions Write a Review

NPPES record last updated: August 19, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 19, 2019, Jul 21, 2017 (2 updates tracked since 2017).

About Davita Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DAVITA MEDICAL GROUP (NPI 1023402088) is a healthcare organization registered as a non-pharmacy dispensing site in Seffner, Florida and active in the NPI registry since March 2015. The organization holds 3 active CLIA laboratory certificates and lists John G. Liethen, Secretary, as its authorized official.

NPPES Registry Identity

NPI1023402088
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameOPTUMCARE FLORIDA, LLC
Location Address770 W DR MARTIN LUTHER KING JR BLVDSeffner, FL 33584-4534
Mailing Address10051 5th St. NorthSaint Petersburg, FL 33702
Phone(813) 654-7005
Organization SubpartNo
Authorized OfficialJohn G. LiethenSecretary · (952) 205-6262
Enumeration DateMarch 26, 2015
Last NPPES UpdateAugust 19, 20192 updates tracked since enumeration
✔ NPI 1023402088 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
License✔ Licensed in FL · OS8544
Definition
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.)
770 W DR MARTIN LUTHER KING JR BLVD, Seffner, FL 33584
Open in Google Maps ↗

Other Names 2

Doing Business AsDavita Medical Group
Doing Business AsJsa Medical Group-seffner

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Sanford Health Plan.Insurance ›

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0702390

Optumcare Florida LLC · Seffner, FL
Active · expires Aug 24, 2027
CLIA Number10D0702390
Laboratory TypePhysician Office
Certificate Effective DateAugust 25, 2025
Certificate Expiration DateAugust 24, 2027
Laboratory DirectorMichael Zane
Laboratory Phone(407) 258-3186
Laboratory LocationOptumcare Florida LLC770 Martin Luther King Blvd W, Seffner, FL 33584
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2046972

Optumcare Florida LLC · Saint Petersburg, FL
Active · expires Sep 13, 2026
CLIA Number10D2046972
Laboratory TypePhysician Office
Certificate Effective DateSeptember 14, 2024
Certificate Expiration DateSeptember 13, 2026
Laboratory DirectorSimarta Brennan-Prescod
Laboratory Phone(407) 258-3186
Laboratory LocationOptumcare Florida LLC8950 Dr Mlk Jr Street N Ste 180, Saint Petersburg, FL 33702
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D0858344

Optumcare Florida LLC · Saint Petersburg, FL
Active · expires Aug 31, 2026
CLIA Number10D0858344
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorBernita Sands
Laboratory Phone(407) 258-3186
Laboratory LocationOptumcare Florida LLC7501 Dr Mlk Jr St N, Saint Petersburg, FL 33702
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHAEL ANTHONY ZANE D.O.
Internal Medicine
770 W DR MARTIN LUTHER KING JR BLVD
SEFFNER, FL 33584
Hillsborough County (813) 654-7005
JACQUELINE ANN TAYLOR MD
Internal Medicine
770 W DR MARTIN LUTHER KING JR BLVD
SEFFNER, FL 33584
Hillsborough County (813) 654-7005
TRICE LININGER A.R.N.P.
Nurse Practitioner
770 W DR MARTIN LUTHER KING JR BLVD
SEFFNER, FL 33584
Hillsborough County (813) 654-7005
DR. JUDITH F PAULINO DE TORIBIO MD
Internal Medicine
770 W DR MARTIN LUTHER KING JR BLVD
SEFFNER, FL 33584
Hillsborough County (813) 654-7005
YAMIRA M ALEMAN RODRIGUEZ FNP
Family Medicine
770 W DR MARTIN LUTHER KING JR BLVD
SEFFNER, FL 33584
Hillsborough County (813) 654-7005
DR. MEERA GHAYAL D.O.
Family Medicine
770 W DR MARTIN LUTHER KING JR BLVD
SEFFNER, FL 33584
Hillsborough County (813) 654-7005
GABRIELLE BETH FRANKENFIELD ARNP
Nurse Practitioner
770 W DR MARTIN LUTHER KING JR BLVD
SEFFNER, FL 33584
Hillsborough County (813) 654-7005
JOSE LUIS SOLER MD
Internal Medicine
770 W DR MARTIN LUTHER KING JR BLVD
SEFFNER, FL 33584
Hillsborough County (813) 654-7005

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Optumcare Florida, LLC's NPI number?

The NPI number for Optumcare Florida, LLC is 1023402088. It was assigned to this organization in the NPPES registry on March 26, 2015. The provider is doing business as Davita Medical Group and JSA Medical Group-Seffner.

Where is Optumcare Florida, LLC located?

Optumcare Florida, LLC is located at 770 W Dr Martin Luther King Jr Blvd, Seffner, FL 33584. The listed phone number is (813) 654-7005.

What is Optumcare Florida, LLC's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

Does Optumcare Florida, LLC hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Optumcare Florida, LLC accept?

Health plans from Sanford Health Plan list Optumcare Florida, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Optumcare Florida, LLC was last updated on August 19, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.