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CUSTOM CARE MEDICAL CENTER LLC
NPI 1487455341
Clinic/Center in Tampa, FL

Active since March 24, 2025CLIA 10D2148276 · Waiver
1931 W MARTIN LUTHER KING JR BLVD, STE E, TAMPA, FL 33607(813) 515-6676(813) 515-6685 Get Directions Write a Review

NPPES record last updated: March 24, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Custom Care Medical Center Llc NPPES

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

CUSTOM CARE MEDICAL CENTER LLC (NPI 1487455341) is a healthcare organization registered as a clinic/center in Tampa, Florida and active in the NPI registry since March 2025. The organization holds a CLIA Waiver certificate valid through May 7, 2028 and lists Douglas Burks, Owner, as its authorized official.

NPPES Registry Identity

NPI1487455341
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameCUSTOM CARE MEDICAL CENTER LLC
Location Address1931 W MARTIN LUTHER KING JR BLVD, STE ETampa, FL 33607
Mailing Address1931 W Martin Luther King Jr Blvd, Ste ETampa, FL 33607 · (813) 515-6676 · Fax (813) 515-6685
Phone(813) 515-6676
Fax(813) 515-6685
Organization SubpartNo
Authorized OfficialDouglas BurksOwner · (813) 515-6676
Enumeration DateMarch 24, 2025
NPPES CertifiedMarch 20, 2025
✔ NPI 1487455341 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).
1931 W MARTIN LUTHER KING JR BLVD, Tampa, FL 33607
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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 10D2148276

Custom Care Medical Center · Tampa, FL
Active · expires May 7, 2028
CLIA Number10D2148276
Laboratory TypePhysician Office
Certificate Effective DateMay 8, 2026
Certificate Expiration DateMay 7, 2028
Laboratory DirectorDouglas Matthew Burks
Laboratory Phone(813) 515-6676
Laboratory LocationCustom Care Medical Center1931 W Mlk, Jr Blvd Ste E, Tampa, FL 33607
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Custom Care Medical Center LLC's NPI number?

The NPI number for Custom Care Medical Center LLC is 1487455341. It was assigned to this organization in the NPPES registry on March 24, 2025.

Where is Custom Care Medical Center LLC located?

Custom Care Medical Center LLC is located at 1931 W Martin Luther King Jr Blvd Ste E, Tampa, FL 33607. The listed phone number is (813) 515-6676.

What is Custom Care Medical Center LLC's specialty?

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

Does Custom Care Medical Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2148276) is associated with this NPI, valid through May 7, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Custom Care Medical Center LLC was last updated on March 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.