DAVITA MEDICAL GROUP
NPI 1558739847
Non-Pharmacy Dispensing Site in Brandon, FL
NPI Status: Active since September 03, 2015
Contact Information
1933 W LUMSDEN RD
BRANDON, FL
ZIP 33511
Phone: (813) 653-3111
- Organization
- Non-Pharmacy Dispensing Site
- Accepts Insurance
- CLIA Number: 10D0675080
- CLIA Cert. Type: Other
- CLIA Exp. Date: 03-24-2028
About DAVITA MEDICAL GROUP
This page provides the complete NPI Profile along with additional information for Davita Medical Group, a provider established in Brandon, Florida operating as a Non-pharmacy Dispensing Site. The healthcare provider is registered in the NPI registry with number 1558739847 assigned on September 2015. The practitioner's primary taxonomy code is 332900000X with license number ME66254 (FL). The provider is registered as an organization and their NPI record was last updated 7 years ago. The provider's is doing business as Davita Medical Group. The authorized official of this NPI record is John G. Liethen (Secretary)
- NPI
- 1558739847
- Provider Legal Name
- OPTUMCARE FLORIDA, LLC
- Other Organization Name
- DAVITA MEDICAL GROUP
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1933 W LUMSDEN RD BRANDON, FL 33511
- Location Phone
- (813) 653-3111
- Mailing Address
- 10051 5TH STREET N. ST. PETERSBURG, FL 33702
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-03-2015
- Last Update Date
- 08-19-2019
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Non-Pharmacy Dispensing Site
- Taxonomy Code
- 332900000X
- Type
- Suppliers
- License No.
- ME66254
- License State
- FL
- Taxonomy Description
- 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.)
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Sanford Individual Simplicity $1,750 - PPO
- Sanford Individual Simplicity $10,600 - PPO
- Sanford Individual Simplicity $3,500 - PPO
- Sanford Individual Simplicity $4,750 - PPO
- Sanford Individual Simplicity $6,500 - PPO
- Sanford Individual Simplicity $7,200 HSA Qualified - PPO
- Sanford Individual Simplicity Standardized $2,000 - PPO
- Sanford Individual Simplicity Standardized $6,000 - PPO
- Sanford Individual Simplicity Standardized $7,500 - PPO
- Sanford Individual TRUE $1,750 - HMO
- Sanford Individual TRUE $10,600 - HMO
- Sanford Individual TRUE $3,500 - HMO
- Sanford Individual TRUE $4,750 - HMO
- Sanford Individual TRUE $6,500 - HMO
- Sanford Individual TRUE $7,200 HSA Qualified - HMO
- Sanford Individual TRUE Standardized $2,000 - HMO
- Sanford Individual TRUE Standardized $6,000 - HMO
- Sanford Individual TRUE Standardized $7,500 - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 10D0675080
- Facility Type
- Other
- Certificate Effective Date
- March 25, 2026
- Certificate Expiration Date
- March 24, 2028
- Laboratory Director
- BRUNILDA NAZARIO
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Davita Medical Group to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1558739847, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 73. The final step is to find the difference between that total and the next multiple of ten (80 - 73 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 73 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1558739847, enumerated as an "organization" on September 03, 2015.
The provider is located at 1933 W LUMSDEN RD BRANDON, FL 33511 and the phone number is (813) 653-3111.
Non-Pharmacy Dispensing Site with taxonomy code 332900000X.
The provider might be accepting Accepts: Sanford Health Plan. Please consult your insurance carrier or call the provider to verify.
