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DAVITA MEDICAL GROUP
NPI 1972997823
Non-Pharmacy Dispensing Site in Bradenton, FL

Active since March 27, 2015CLIA 10D1034428 · Waiver
5534 CORTEZ RD W, BRADENTON, FL 34210(941) 757-2100 Get Directions Write a Review

NPPES record last updated: August 19, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 19, 2019, Jul 21, 2017 (2 updates tracked since 2017).

About Davita Medical Group NPPES

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

DAVITA MEDICAL GROUP (NPI 1972997823) is a healthcare organization registered as a non-pharmacy dispensing site in Bradenton, Florida and active in the NPI registry since March 2015. The organization holds a CLIA Waiver certificate valid through December 1, 2026 and lists John G. Liethen, Secretary, as its authorized official.

NPPES Registry Identity

NPI1972997823
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameOPTUMCARE FLORIDA, LLC
Location Address5534 CORTEZ RD WBradenton, FL 34210-2817
Mailing Address10051 5th Street N.St. Petersburg, FL 33702
Phone(941) 757-2100
Organization SubpartNo
Authorized OfficialJohn G. LiethenSecretary · (952) 205-6262
Enumeration DateMarch 27, 2015
Last NPPES UpdateAugust 19, 20192 updates tracked since enumeration
✔ NPI 1972997823 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
License✔ Licensed in FL · ME113725
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.)

5534 CORTEZ RD W, Bradenton, FL 34210
Open in Google Maps ↗

Other Names 1

Doing Business AsDavita Medical Group

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Sanford Health Plan.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 10D1034428

Optumcare Florida LLC · Bradenton, FL
Active · expires Dec 1, 2026
CLIA Number10D1034428
Laboratory TypePhysician Office
Certificate Effective DateDecember 2, 2024
Certificate Expiration DateDecember 1, 2026
Laboratory DirectorNiki Derrick
Laboratory Phone(407) 258-3186
Laboratory LocationOptumcare Florida LLC5534 Cortez Road West, Bradenton, FL 34210
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

STEPHEN SHANKLIN DO
Family Medicine
5534 CORTEZ RD W
BRADENTON, FL 34210
Manatee County (941) 757-2100
NIKI LYNN DERRICK APRN
Nurse Practitioner (Family)
5534 CORTEZ RD W
BRADENTON, FL 34210
Manatee County (941) 757-2100
MS. SUZANNE WARE PA-C
Physician Assistant
5534 CORTEZ RD W
BRADENTON, FL 34210
Manatee County (971) 757-2100
ANESS AL-KHATEEB MD
Hospitalist
5534 CORTEZ RD W
BRADENTON, FL 34210
Manatee County (941) 757-2100
JIMMY DUY NGUYEN DNP
Nurse Practitioner (Family)
5534 CORTEZ RD W
BRADENTON, FL 34210
Manatee County (941) 757-2100

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 Optumcare Florida, LLC's NPI number?

The NPI number for Optumcare Florida, LLC is 1972997823. It was assigned to this organization in the NPPES registry on March 27, 2015. The provider is doing business as Davita Medical Group.

Where is Optumcare Florida, LLC located?

Optumcare Florida, LLC is located at 5534 Cortez Rd W, Bradenton, FL 34210. The listed phone number is (941) 757-2100.

What is Optumcare Florida, LLC's specialty?

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

Does Optumcare Florida, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D1034428) is associated with this NPI, valid through December 1, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Optumcare Florida, LLC accept?

Health plans from Sanford Health Plan list Optumcare Florida, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Optumcare Florida, LLC was last updated on August 19, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.