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SOUTHSIDE MEDICAL CLINIC
NPI 1356681845
Clinic/Center in Lakeland, FL

Active since February 21, 2013
1707 E EDGEWOOD DR, LAKELAND, FL 33803(863) 688-9219(863) 687-4863 Get Directions Write a Review

NPPES record last updated: February 21, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Southside Medical Clinic NPPES

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

SOUTHSIDE MEDICAL CLINIC (NPI 1356681845) is a healthcare organization registered as a clinic/center in Lakeland, Florida and active in the NPI registry since February 2013. The organization lists Roger David Suares, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1356681845
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameSOUTHSIDE MEDICAL CLINIC
Location Address1707 E EDGEWOOD DRLakeland, FL 33803-3470
Mailing Address1707 E Edgewood DrLakeland, FL 33803-3470 · (863) 688-9219 · Fax (863) 687-4863
Phone(863) 688-9219
Fax(863) 687-4863
Organization SubpartNo
Authorized OfficialRoger David SuaresMedical Director · (863) 688-9219
Enumeration DateFebruary 21, 2013
✔ NPI 1356681845 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 · ME0043239
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).
1707 E EDGEWOOD DR, Lakeland, FL 33803
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Other Identifiers 1

Medicare UPIND62005FL

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 Southside Medical Clinic's NPI number?

The NPI number for Southside Medical Clinic is 1356681845. It was assigned to this organization in the NPPES registry on February 21, 2013.

Where is Southside Medical Clinic located?

Southside Medical Clinic is located at 1707 E Edgewood Dr, Lakeland, FL 33803. The listed phone number is (863) 688-9219.

What is Southside Medical Clinic'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 Southside Medical Clinic was last updated on February 21, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.