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FLORIDA INTERNAL MEDICINE PA
NPI 1831136274
Internal Medicine in Lake Mary, FL

Active since June 02, 2006CLIA 10D0273655 · Waiver
4106 W LAKE MARY BLVD, SUITE 301, LAKE MARY, FL 32746(407) 333-2503(407) 333-0962 Get Directions Write a Review

NPPES record last updated: August 23, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Florida Internal Medicine Pa NPPES

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

FLORIDA INTERNAL MEDICINE PA (NPI 1831136274) is a healthcare organization registered as an internal medicine in Lake Mary, Florida and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through September 30, 2027 and lists Glen F Davis, President, as its authorized official.

NPPES Registry Identity

NPI1831136274
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameFLORIDA INTERNAL MEDICINE PA
Location Address4106 W LAKE MARY BLVD, SUITE 301Lake Mary, FL 32746-3315
Mailing Address4106 W Lake Mary Blvd, Suite 301Lake Mary, FL 32746-3315 · (407) 333-2503 · Fax (407) 333-0962
Phone(407) 333-2503
Fax(407) 333-0962
Organization SubpartNo
Authorized OfficialGlen F DavisPresident · (407) 333-2503
Enumeration DateJune 2, 2006
Last NPPES UpdateAugust 23, 2007
✔ NPI 1831136274 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
4106 W LAKE MARY BLVD, Lake Mary, FL 32746
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Other Identifiers 5

Medicare ID-Type Unspecified59294ZFL · Glen F. Davis, M.d.
Medicare ID-Type Unspecified59938ZFL · John F. Ryan, M.d.
Medicare UPINE11977FL
Medicare UPIN59294ZFL
Medicare ID-Type Unspecified98593FL · Florida Internal Medicine

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Florida Internal Medicine Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Florida Internal Medicine PA, which bills Medicare for the services they deliver. Of these, 3 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

John Ryan, M.D.
Internal Medicine
NPI 1144266974
4106 W LAKE MARY BLVD STE 301
Lake Mary, FL 32746
(407) 333-2503
✔ PECOS✔ Accepts Medicare0.1 mi
Glen Davis, M.D.
Internal Medicine
NPI 1689617813
4106 W LAKE MARY BLVD SUITE 301
Lake Mary, FL 32746
(407) 333-2503
✔ PECOS0.1 mi
Nicole Rodriguez, NURSE PRACTITIONER
Nurse Practitioner
NPI 1609346378
4106 W LAKE MARY BLVD
Lake Mary, FL 32746
(407) 333-2503
✔ PECOS✔ Accepts Medicare0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 10D0273655

Florida Internal Medicine · Lake Mary, FL
Active · expires Sep 30, 2027
CLIA Number10D0273655
Laboratory TypePhysician Office
Certificate Effective DateOctober 1, 2025
Certificate Expiration DateSeptember 30, 2027
Laboratory DirectorJohn F. Ryan
Laboratory Phone(407) 333-2503
Laboratory LocationFlorida Internal Medicine4106 W Lake Mary Blvd Ste 301, Lake Mary, FL 32746
CLIA data matches this NPI record on: Address 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 Florida Internal Medicine PA's NPI number?

The NPI number for Florida Internal Medicine PA is 1831136274. It was assigned to this organization in the NPPES registry on June 2, 2006.

Where is Florida Internal Medicine PA located?

Florida Internal Medicine PA is located at 4106 W Lake Mary Blvd Suite 301, Lake Mary, FL 32746. The listed phone number is (407) 333-2503.

What is Florida Internal Medicine PA's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Florida Internal Medicine PA enrolled in Medicare?

Yes. Florida Internal Medicine PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Florida Internal Medicine PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Florida Internal Medicine PA, in Internal Medicine and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Florida Internal Medicine PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0273655) is associated with this NPI, valid through September 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Florida Internal Medicine PA was last updated on August 23, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.