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DAVITA MEDICAL GROUP
NPI 1356737399
Non-Pharmacy Dispensing Site in Tampa, FL

Active since April 07, 2015CLIA 10D0875918 · Waiver
3675 W WATERS AVE, TAMPA, FL 33614(813) 915-2000 Get Directions Write a Review

NPPES record last updated: August 19, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 19, 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 1356737399) is a healthcare organization registered as a non-pharmacy dispensing site in Tampa, Florida and active in the NPI registry since April 2015. The organization holds a CLIA Waiver certificate valid through February 17, 2028 and lists John G. Liethen, Secretary, as its authorized official.

NPPES Registry Identity

NPI1356737399
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameOPTUMCARE FLORIDA, LLC
Location Address3675 W WATERS AVETampa, FL 33614-2783
Mailing Address10051 5th Street NSt. Petersburg, FL 33702-7701
Phone(813) 915-2000
Organization SubpartNo
Authorized OfficialJohn G. LiethenSecretary · (952) 205-6262
Enumeration DateApril 7, 2015
Last NPPES UpdateAugust 19, 20192 updates tracked since enumeration
✔ NPI 1356737399 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 · OS8662
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.)
3675 W WATERS AVE, Tampa, FL 33614
Open in Google Maps ↗

Other Names 1

Doing Business AsDavita Medical Group

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Sanford Health Plan.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 10D0875918

Optumcare Florida LLC · Tampa, FL
Active · expires Feb 17, 2028
CLIA Number10D0875918
Laboratory TypePhysician Office
Certificate Effective DateFebruary 18, 2026
Certificate Expiration DateFebruary 17, 2028
Laboratory DirectorJuan Amador-Tavarez
Laboratory Phone(813) 915-2000
Laboratory LocationOptumcare Florida LLC3675 W Waters Ave, Tampa, FL 33614
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

HEALTHPOINT MEDICAL GROUP INC
Pediatrics
3675 W WATERS AVE
TAMPA, FL 33614
Hillsborough County (813) 931-1679
BARBARA PIERRE-LOUIS ARNP
Nurse Practitioner (Family)
3675 W WATERS AVE
TAMPA, FL 33614
Hillsborough County (813) 915-2000
DR. MILDRED E. PAZMINO-VERA M.D.
Family Medicine
3675 W WATERS AVE
TAMPA, FL 33614
Hillsborough County (813) 915-2000
FRANCISCO TOMAS FERNANDEZ RODRIGUEZ M.D.
Internal Medicine
3675 W WATERS AVE
TAMPA, FL 33614
Hillsborough County (813) 915-2000

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 1356737399. It was assigned to this organization in the NPPES registry on April 7, 2015. The provider is doing business as Davita Medical Group.

Where is Optumcare Florida, LLC located?

Optumcare Florida, LLC is located at 3675 W Waters Ave, Tampa, FL 33614. The listed phone number is (813) 915-2000.

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 10D0875918) is associated with this NPI, valid through February 17, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Optumcare Florida, LLC accept?

Health plans from Sanford Health Plan list Optumcare Florida, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Optumcare Florida, LLC was last updated on August 19, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.