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SUNLAKE MEDICAL ASSOCIATES
NPI 1114153483
Clinic/Center in Lutz, FL

Active since June 01, 2009
18964 DALE MABRY HWY N, STE 101, LUTZ, FL 33548(813) 948-2107(813) 948-2790 Get Directions Write a Review

NPPES record last updated: April 1, 2010. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Sunlake Medical Associates NPPES

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

SUNLAKE MEDICAL ASSOCIATES (NPI 1114153483) is a healthcare organization registered as a clinic/center in Lutz, Florida and active in the NPI registry since June 2009. The organization lists Luis A. Logrono, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1114153483
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameSUNLAKE PAIN MANAGEMENT, LLC
Location Address18964 DALE MABRY HWY N, STE 101Lutz, FL 33548-4913
Mailing Address18964 Dale Mabry Hwy N, Ste 101Lutz, FL 33548-4913 · (813) 948-2107 · Fax (813) 948-2790
Phone(813) 948-2107
Fax(813) 948-2790
Organization SubpartNo
Authorized OfficialLuis A. LogronoMedical Director · (813) 948-2107
Enumeration DateJune 1, 2009
Last NPPES UpdateApril 1, 2010
✔ NPI 1114153483 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in FL · HCC8458
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
18964 DALE MABRY HWY N, Lutz, FL 33548
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Other Names 1

Doing Business AsSunlake Medical Associates

Other Identifiers 1

Medicare PINCI914AFL

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sunlake Medical Associates is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateFloridaEnrollment IDO20091211000660Non-DME Part B · Clinic/Group PracticeDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Sunlake Medical Associates, which bills Medicare for the services this clinician delivers.

Clinician (1)

Luis Logrono, MD
Internal Medicine
NPI 1700875739
18964 DALE MABRY HWY N SUITE 101
Lutz, FL 33548
(813) 948-2107
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Sunlake Pain Management, LLC's NPI number?

The NPI number for Sunlake Pain Management, LLC is 1114153483. It was assigned to this organization in the NPPES registry on June 1, 2009. The provider is doing business as Sunlake Medical Associates.

Where is Sunlake Pain Management, LLC located?

Sunlake Pain Management, LLC is located at 18964 Dale Mabry Hwy N Ste 101, Lutz, FL 33548. The listed phone number is (813) 948-2107.

What is Sunlake Pain Management, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Sunlake Pain Management, LLC enrolled in Medicare?

Yes. Sunlake Pain Management, LLC is registered in the Medicare PECOS enrollment system.

When is Sunlake Pain Management, LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Florida, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Sunlake Pain Management, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Sunlake Pain Management, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Sunlake Pain Management, LLC was last updated on April 1, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.