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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

PELHAM MEDICAL PRACTICE & AESTHETIC LOUNGE, LLC.
NPI 1639876733
Nurse Practitioner - Family in Orlando, FL

Active since February 09, 2023CLIA 10D2347874 · Waiver
5979 VINELAND RD STE 207, ORLANDO, FL 32819(407) 893-1181(407) 440-8269 Get Directions Write a Review

NPPES record last updated: July 28, 2026. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Jul 28, 2026, Feb 9, 2023 (2 updates tracked since 2023).

About Pelham Medical Practice & Aesthetic Lounge, Llc. NPPES

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

PELHAM MEDICAL PRACTICE & AESTHETIC LOUNGE, LLC. (NPI 1639876733), doing business as Pelham Medical Consulting & Aesthetic Lounge, Llc., is a healthcare organization registered as a family in Orlando, Florida and active in the NPI registry since February 2023. The organization holds a CLIA Waiver certificate valid through July 26, 2028 and lists Janadra Dean Greenidge, Owner, as its authorized official.

NPPES Registry Identity

NPI1639876733
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NamePELHAM MEDICAL PRACTICE & AESTHETIC LOUNGE, LLC.
Location Address5979 VINELAND RD STE 207Orlando, FL 32819-7855
Mailing Address5979 Vineland Rd Ste 207, Suite 207Orlando, FL 32819-7855 · (407) 893-1181 · Fax (407) 440-8269
Phone(407) 893-1181
Fax(407) 440-8269
Organization SubpartNo
Authorized OfficialJanadra Dean GreenidgeOwner · (407) 893-1181
Enumeration DateFebruary 9, 2023
Last NPPES UpdateJuly 28, 20262 updates tracked since enumeration
NPPES CertifiedJuly 28, 2026
✔ NPI 1639876733 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
5979 VINELAND RD STE 207, Orlando, FL 32819
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Other Names 1

Former Legal Business NamePelham Medical Consulting & Aesthetic Lounge, Llc.

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 10D2347874

Pelham Medical Practice & Aesthetic Lounge, LLC · Orlando, FL
Active · expires Jul 26, 2028
CLIA Number10D2347874
Laboratory TypeDiagnostic Testing
Certificate Effective DateJuly 27, 2026
Certificate Expiration DateJuly 26, 2028
Laboratory DirectorFaedra E. Greenidge
Laboratory Phone(407) 893-1181
Laboratory LocationPelham Medical Practice & Aesthetic Lounge, LLC5979 Vineland Rd Suite 207, Orlando, FL 32819
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 3

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

DR. CLAIRE MARIE CYPRIEN M.D.
Anesthesiology (Pain Medicine)
5979 VINELAND RD STE 207
ORLANDO, FL 32819
Orange County (407) 345-0065
SOUTHWEST ANESTHESIA AND PAIN MANAGEMENT PA
Clinic/Center (Pain)
5979 VINELAND RD STE 207
ORLANDO, FL 32819
Orange County (407) 345-0065
MISS JANADRA DEAN GREENIDGE APRN
Nurse Practitioner (Primary Care)
5979 VINELAND RD STE 207
ORLANDO, FL 32819
Orange County (407) 893-1181

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 Pelham Medical Practice & Aesthetic Lounge, LLC.'s NPI number?

The NPI number for Pelham Medical Practice & Aesthetic Lounge, LLC. is 1639876733. It was assigned to this organization in the NPPES registry on February 9, 2023. The provider was formerly known as Pelham Medical Consulting & Aesthetic Lounge, LLC..

Where is Pelham Medical Practice & Aesthetic Lounge, LLC. located?

Pelham Medical Practice & Aesthetic Lounge, LLC. is located at 5979 Vineland Rd Ste 207, Orlando, FL 32819. The listed phone number is (407) 893-1181.

What is Pelham Medical Practice & Aesthetic Lounge, LLC.'s specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Pelham Medical Practice & Aesthetic Lounge, LLC. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2347874) is associated with this NPI, valid through July 26, 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 Pelham Medical Practice & Aesthetic Lounge, LLC. was last updated on July 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 51 days 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.