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DAVITA MEDICAL GROUP
NPI 1043687072
Non-Pharmacy Dispensing Site in Tampa, FL

Active since August 25, 2015CLIA 10D2041967 · Waiver
2727 W DR MLK BLVD, SUITE 850, TAMPA, FL 33607(813) 871-2717 Get Directions Write a Review

NPPES record last updated: August 20, 2019. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Aug 20, 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 1043687072) is a healthcare organization registered as a non-pharmacy dispensing site in Tampa, Florida and active in the NPI registry since August 2015. The organization holds a CLIA Waiver certificate valid through January 22, 2028 and lists John G. Liethen, Secretary, as its authorized official.

NPPES Registry Identity

NPI1043687072
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameOPTUMCARE FLORIDA, LLC
Location Address2727 W DR MLK BLVD, SUITE 850Tampa, FL 33607-6383
Mailing Address10051 5th Street N., Suite 200St. Petersburg, FL 33702
Phone(813) 871-2717
Organization SubpartNo
Authorized OfficialJohn G. LiethenSecretary · (952) 205-6262
Enumeration DateAugust 25, 2015
Last NPPES UpdateAugust 20, 20192 updates tracked since enumeration
✔ NPI 1043687072 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 · ME81584
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.)
2727 W DR MLK BLVD, Tampa, FL 33607
Open in Google Maps ↗

Other Names 1

Doing Business AsDavita Medical Group

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 10D2041967

Optumcare Florida, LLC · Tampa, FL
Active · expires Jan 22, 2028
CLIA Number10D2041967
Laboratory TypePhysician Office
Certificate Effective DateJanuary 23, 2026
Certificate Expiration DateJanuary 22, 2028
Laboratory DirectorAlisa Holland
Laboratory Phone(407) 258-3186
Laboratory LocationOptumcare Florida, LLC2701 W Saint Isabel St, Tampa, FL 33607
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 5

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

MRS. YVONNE ZAKKAY MD
Internal Medicine
2727 W DR MLK BLVD, STE 630
TAMPA, FL 33607
Hillsborough County (813) 876-6000
BEHAVIORAL HEALTH MANAGEMENT SERVICES, INC.
Clinic/Center (Mental Health (Including Community Mental Health Center))
2727 W DR MLK BLVD, SUITE 640
TAMPA, FL 33607
Hillsborough County (813) 872-7582
PREMIER OB GYN OF TAMPA LLP
Obstetrics & Gynecology
2727 W DR MLK BLVD, SUITE 630
TAMPA, FL 33607
Hillsborough County (813) 935-8998
JOHN STEVEN COFFMAN AA-C
Anesthesiologist Assistant
2727 W DR MLK BLVD, SUITE 310
TAMPA, FL 33607
Hillsborough County (813) 350-7244
DARINA CARCERANO NP
Nurse Practitioner (Psychiatric/Mental Health)
2727 W DR MLK BLVD
TAMPA, FL 33607
Hillsborough County (866) 762-1743

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 1043687072. It was assigned to this organization in the NPPES registry on August 25, 2015. The provider is doing business as Davita Medical Group.

Where is Optumcare Florida, LLC located?

Optumcare Florida, LLC is located at 2727 W Dr Mlk Blvd Suite 850, Tampa, FL 33607. The listed phone number is (813) 871-2717.

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 a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2041967) is associated with this NPI, valid through January 22, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Optumcare Florida, LLC was last updated on August 20, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.