DEDICATED SENIOR MEDICAL CENTERS OF FLORIDA, LLC - NPI 1710649769 - Non-Pharmacy Dispensing Site in St Petersburg, FL

Q: What is Dedicated Senior Medical Centers Of Florida, LLC's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

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About Dedicated Senior Medical Centers Of Florida, Llc NPPES

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

DEDICATED SENIOR MEDICAL CENTERS OF FLORIDA, LLC (NPI 1710649769), doing business as Dedicated Senior Medical Center Lealman, is a healthcare organization registered as a non-pharmacy dispensing site in St Petersburg, Florida and active in the NPI registry since October 2021. The organization holds a CLIA Waiver certificate valid through July 13, 2028 and lists Mary Chen, Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1710649769

Entity TypeOrganization

Primary Taxonomy332900000X

Legal Business NameDEDICATED SENIOR MEDICAL CENTERS OF FLORIDA, LLC

Location Address2805 54TH AVE N STE 500St Petersburg, FL 33714-2414

Mailing Address1395 Nw 167th StMiami Gardens, FL 33169-5710 · (305) 628-6117

Phone(727) 341-5800

Fax(727) 341-5307

Organization SubpartYes

Authorized OfficialMary ChenExecutive Officer · (305) 628-6117

Enumeration DateOctober 7, 2021

NPPES CertifiedOctober 7, 2021

✔ NPI 1710649769 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers

Taxonomy Code332900000X

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.)

2805 54TH AVE N STE 500, St Petersburg, FL 33714

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Other Names 1

Doing Business AsDedicated Senior Medical Center Lealman

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.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 10D2264411

Dedicated Senior Medical Center Lealman · Saint Petersburg, FL

Active · expires Jul 13, 2028

CLIA Number10D2264411

Laboratory TypePhysician Office

Certificate Effective DateJuly 14, 2026

Certificate Expiration DateJuly 13, 2028

Laboratory DirectorChristopher Chen

Laboratory Phone(727) 341-5800

Laboratory LocationDedicated Senior Medical Center Lealman2805 54th Ave N - Ste 500, Saint Petersburg, FL 33705

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

JULAINE BRAHAM MD

Internal Medicine