FOUR CORNERS MEDICAL CENTER, LLC
NPI 1295678605
Clinic/Center in Davenport, FL

Active since April 10, 2026
106 POLO PARK EAST BLVD, DAVENPORT, FL 33897(863) 424-8900(863) 424-8823 Get Directions Write a Review

NPPES record last updated: April 10, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Four Corners Medical Center, Llc NPPES

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

FOUR CORNERS MEDICAL CENTER, LLC (NPI 1295678605) is a healthcare organization registered as a clinic/center in Davenport, Florida and active in the NPI registry since April 2026. The organization lists Srinath R Kosanam, President-owner, as its authorized official.

NPPES Registry Identity

NPI1295678605
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameFOUR CORNERS MEDICAL CENTER, LLC
Location Address106 POLO PARK EAST BLVDDavenport, FL 33897-9407
Mailing Address10603 Emerald Chase DrOrlando, FL 32836-5855 · (407) 844-7323 · Fax (863) 424-8823
Fax(863) 424-8823
Organization SubpartNo
Authorized OfficialSrinath R KosanamPresident-owner · (407) 844-7323
Enumeration DateApril 10, 2026
NPPES CertifiedApril 10, 2026
NPI 1295678605 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
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).
106 POLO PARK EAST BLVD, Davenport, FL 33897

Other Providers at the Same Location NPPES 2

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

Internal Medicine
106 POLO PARK EAST BLVD
DAVENPORT, FL 33897
Clinic/Center
106 POLO PARK EAST BLVD
DAVENPORT, FL 33897

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 Four Corners Medical Center, LLC's NPI number?

The NPI number for Four Corners Medical Center, LLC is 1295678605. It was assigned to this organization in the NPPES registry on April 10, 2026.

Where is Four Corners Medical Center, LLC located?

Four Corners Medical Center, LLC is located at 106 Polo Park East Blvd, Davenport, FL 33897. The listed phone number is (863) 424-8900.

What is Four Corners Medical Center, LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Four Corners Medical Center, LLC was last updated on April 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.