ADVENTHEALTH SURGERY CENTER DAVENPORT LLC
NPI 1295479780
Clinic/Center - Ambulatory Surgical in Davenport, FL

Q: What is Adventhealth Surgery Center Davenport LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Active since April 21, 2022CLIA 10D2107433 · Waiver

107 PARK PLACE BLVD, DAVENPORT, FL 33837(863) 419-2812(863) 419-2821 Get Directions Write a Review

NPPES record last updated: June 22, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 6, 2024, Aug 20, 2024, Apr 21, 2022 (3 updates tracked since 2022).

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About Adventhealth Surgery Center Davenport Llc NPPES

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

ADVENTHEALTH SURGERY CENTER DAVENPORT LLC (NPI 1295479780) is a healthcare organization registered as an ambulatory surgical in Davenport, Florida and active in the NPI registry since April 2022. The organization holds a CLIA Waiver certificate valid through January 12, 2028 and lists Collin Lemaistre, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1295479780

Entity TypeOrganization

Primary Taxonomy261QA1903X

Legal Business NameADVENTHEALTH SURGERY CENTER DAVENPORT LLC

Location Address107 PARK PLACE BLVDDavenport, FL 33837-6858

Mailing Address107 Park Place BlvdDavenport, FL 33837-6858 · (863) 419-2812 · Fax (863) 419-2821

Phone(863) 419-2812

Fax(863) 419-2821

Organization SubpartNo

Authorized OfficialCollin LemaistreAuthorized Official · (214) 213-0732

Enumeration DateApril 21, 2022

Last NPPES UpdateJune 22, 20263 updates tracked since enumeration

NPPES CertifiedJune 22, 2026

✔ NPI 1295479780 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities

Taxonomy Code261QA1903X

107 PARK PLACE BLVD, Davenport, FL 33837

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

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 10D2107433

Adventhealth Surgery Center Davenport LLC · Davenport, FL

Active · expires Jan 12, 2028

CLIA Number10D2107433

Laboratory TypeAmbulatory Surgery Center

Certificate Effective DateJanuary 13, 2026

Certificate Expiration DateJanuary 12, 2028

Laboratory DirectorDevendra Kahlon

Laboratory Phone(863) 419-2812

Laboratory LocationAdventhealth Surgery Center Davenport LLC107 Park Place Blvd, Davenport, FL 33837

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 16

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of cataract with insertion of prosthetic lens 66984

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

259 services174 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level 64483

This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.

72 services31 patients

Injection of lower or sacral spine facet joint using imaging guidance, single level 64493

This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.

66 services25 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

59 services59 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

52 services52 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

39 services39 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

35 services35 patients

Injection of upper or middle spine facet joint using imaging guidance, single level 64490

This procedure involves injecting medication into a joint in your upper or middle spine. It's performed under imaging guidance for precision. The aim is to reduce inflammation and pain. It's a single-level process, meaning one joint is treated at a time.

32 services18 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

31 services30 patients

Dilation of esophagus 43450

Dilation of the esophagus is a procedure aimed to stretch or open up your esophagus (the tube connecting your mouth to your stomach) when it's narrow. It helps to improve swallowing and alleviate discomfort. It's typically performed using a flexible tube or balloon, under sedation.

29 services28 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint 64635

This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.

21 services11 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

20 services20 patients

Injection of substance into lower spine canal using imaging guidance 62323

This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.

19 services14 patients

Complex removal of cataract with insertion of prosthetic lens 66982

This procedure involves removing a cloudy lens (cataract) from your eye and replacing it with a clear, artificial lens. It helps restore vision that has been affected by the cataract. The operation is usually done under local anesthesia.

15 services15 patients

Injection of substance into middle or upper spine canal using imaging guidance 62321

This procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.

12 services11 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

12 services12 patients

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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.

ALJAHRA M GUILLAUME

Nurse Anesthetist, Certified Registered