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PALM MEDICAL CENTER LAKELAND LLC
NPI 1932796232
Clinic/Center in Tampa, FL

Active since December 22, 2020CLIA 10D0290558 · Waiver
116 W BOUGAINVILLEA AVE, TAMPA, FL 33612(813) 932-4381 Get Directions Write a Review

NPPES record last updated: December 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Palm Medical Center Lakeland Llc NPPES

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

PALM MEDICAL CENTER LAKELAND LLC (NPI 1932796232) is a healthcare organization registered as a clinic/center in Tampa, Florida and active in the NPI registry since December 2020. The organization holds a CLIA Waiver certificate valid through June 8, 2027 and lists Fowad Choudhry, Coo, as its authorized official.

NPPES Registry Identity

NPI1932796232
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NamePALM MEDICAL CENTER LAKELAND LLC
Location Address116 W BOUGAINVILLEA AVETampa, FL 33612-7437
Mailing Address2600 S Douglas Rd Ste 308Coral Gables, FL 33134-6134 · (786) 814-4790
Phone(813) 932-4381
Organization SubpartNo
Authorized OfficialFowad ChoudhryCoo · (786) 814-4790
Enumeration DateDecember 22, 2020
NPPES CertifiedDecember 22, 2020
✔ NPI 1932796232 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).
116 W BOUGAINVILLEA AVE, Tampa, FL 33612
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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 10D0290558

Palm Medical Center Lakeland, LLC · Tampa, FL
Active · expires Jun 8, 2027
CLIA Number10D0290558
Laboratory TypePhysician Office
Certificate Effective DateJune 9, 2025
Certificate Expiration DateJune 8, 2027
Laboratory DirectorChandravadan J. Patel
Laboratory Phone(813) 932-4381
Laboratory LocationPalm Medical Center Lakeland, LLC116 W Bougainvillea Avenue, Tampa, FL 33612
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 7

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

FAY MARIE CAMERON ARNP
Nurse Practitioner (Adult Health)
116 W BOUGAINVILLEA AVE
TAMPA, FL 33612
Hillsborough County (813) 932-4381
PRITI P PATEL M. D.
Internal Medicine
116 W BOUGAINVILLEA AVE
TAMPA, FL 33612
Hillsborough County (813) 932-4381
CHANDRAVADAN JASHBHAI PATEL MD
Internal Medicine
116 W BOUGAINVILLEA AVE
TAMPA, FL 33612
Hillsborough County (813) 932-4381
YEISY HERNANDEZ LORENTE FNP-C
Nurse Practitioner (Primary Care)
116 W BOUGAINVILLEA AVE
TAMPA, FL 33612
Hillsborough County (813) 932-4381
SANJIV KISHOR DESAI MD
Family Medicine
116 W BOUGAINVILLEA AVE
TAMPA, FL 33612
Hillsborough County (813) 932-4381
LORNA HICHER
Nurse Practitioner (Family)
116 W BOUGAINVILLEA AVE
TAMPA, FL 33612
Hillsborough County (813) 932-4381
DR. DEVJIT HALDER M.D
Internal Medicine
116 W BOUGAINVILLEA AVE
TAMPA, FL 33612
Hillsborough County (813) 932-4381

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 Palm Medical Center Lakeland LLC's NPI number?

The NPI number for Palm Medical Center Lakeland LLC is 1932796232. It was assigned to this organization in the NPPES registry on December 22, 2020.

Where is Palm Medical Center Lakeland LLC located?

Palm Medical Center Lakeland LLC is located at 116 W Bougainvillea Ave, Tampa, FL 33612. The listed phone number is (813) 932-4381.

What is Palm Medical Center Lakeland LLC's specialty?

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

Does Palm Medical Center Lakeland LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0290558) is associated with this NPI, valid through June 8, 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 Palm Medical Center Lakeland LLC was last updated on December 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.