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IMA WINTER HAVEN DISPENSARY
NPI 1033648233
Non-Pharmacy Dispensing Site in Winter Haven, FL

Active since June 09, 2017CLIA 10D2053191 · Waiver
199 AVENUE K SE, WINTER HAVEN, FL 33880(863) 299-6700(863) 293-6359 Get Directions Write a Review

NPPES record last updated: June 13, 2017. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jun 13, 2017, Jun 9, 2017 (2 updates tracked since 2017).

About Ima Winter Haven Dispensary NPPES

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

IMA WINTER HAVEN DISPENSARY (NPI 1033648233) is a healthcare organization registered as a non-pharmacy dispensing site in Winter Haven, Florida and active in the NPI registry since June 2017. The organization holds a CLIA Waiver certificate valid through January 27, 2027 and lists Patricia Pichardo, Coo, as its authorized official.

NPPES Registry Identity

NPI1033648233
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameMEDICAL HOME ALLIANCE LLC
Location Address199 AVENUE K SEWinter Haven, FL 33880-4002
Mailing Address6675 Westwood Blvd Ste 475Orlando, FL 32821-6027 · (407) 845-0330 · Fax (888) 972-1752
Phone(863) 299-6700
Fax(863) 293-6359
Organization SubpartYesParent: Inhealth Md Alliance
Authorized OfficialPatricia PichardoCoo · (407) 845-0330
Enumeration DateJune 9, 2017
Last NPPES UpdateJune 13, 20172 updates tracked since enumeration
✔ NPI 1033648233 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
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.)
199 AVENUE K SE, Winter Haven, FL 33880
Open in Google Maps ↗

Other Names 1

Doing Business AsIma Winter Haven Dispensary

CLIA Laboratory Certificates CMS CLIA

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 10D2053191

Medical Home Alliance LLC · Winter Haven, FL
Active · expires Jan 27, 2027
CLIA Number10D2053191
Laboratory TypePhysician Office
Certificate Effective DateJanuary 28, 2025
Certificate Expiration DateJanuary 27, 2027
Laboratory DirectorKarol Fortich Serje
Laboratory Phone(863) 299-6700
Laboratory LocationMedical Home Alliance LLC151 2nd Street SW, Winter Haven, FL 33880
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

RAMON EZEQUIEL ACOSTA M.D.
General Practice
199 AVENUE K SE
WINTER HAVEN, FL 33880
Polk County (863) 299-6700

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 Medical Home Alliance LLC's NPI number?

The NPI number for Medical Home Alliance LLC is 1033648233. It was assigned to this organization in the NPPES registry on June 9, 2017. The provider is doing business as Ima Winter Haven Dispensary.

Where is Medical Home Alliance LLC located?

Medical Home Alliance LLC is located at 199 Avenue K SE, Winter Haven, FL 33880. The listed phone number is (863) 299-6700.

What is Medical Home Alliance LLC's specialty?

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

Does Medical Home Alliance LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2053191) is associated with this NPI, valid through January 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Medical Home Alliance LLC was last updated on June 13, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.