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CARROLLWOOD MEDICAL GROUP, LLC.
NPI 1982150348
Clinic/Center in Tampa, FL

Active since August 26, 2016CLIA 10D2118999 · Waiver
10213 LAKE CARROLL WAY STE B, TAMPA, FL 33618(813) 888-8215(813) 885-5398 Get Directions Write a Review

NPPES record last updated: February 10, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 10, 2025, Dec 2, 2024, Aug 26, 2016 (3 updates tracked since 2016).

About Carrollwood Medical Group, Llc. NPPES

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

CARROLLWOOD MEDICAL GROUP, LLC. (NPI 1982150348), doing business as Revello Medical Center, is a healthcare organization registered as a clinic/center in Tampa, Florida and active in the NPI registry since August 2016. The organization holds a CLIA Waiver certificate valid through September 18, 2026 and lists Antonio Calvo, Coo, as its authorized official.

NPPES Registry Identity

NPI1982150348
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameCARROLLWOOD MEDICAL GROUP, LLC.
Location Address10213 LAKE CARROLL WAY STE BTampa, FL 33618-4402
Mailing Address5901 Webb RdTampa, FL 33615-3219 · (813) 888-8215 · Fax (813) 885-5398
Phone(813) 888-8215
Fax(813) 885-5398
Organization SubpartNo
Authorized OfficialAntonio CalvoCoo · (813) 888-8215
Enumeration DateAugust 26, 2016
Last NPPES UpdateFebruary 10, 20253 updates tracked since enumeration
NPPES CertifiedFebruary 10, 2025
✔ NPI 1982150348 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).
10213 LAKE CARROLL WAY STE B, Tampa, FL 33618
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Other Names 1

Doing Business AsRevello Medical Center

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 10D2118999

Carrollwood Medical Group · Tampa, FL
Active · expires Sep 18, 2026
CLIA Number10D2118999
Laboratory TypePhysician Office
Certificate Effective DateSeptember 19, 2024
Certificate Expiration DateSeptember 18, 2026
Laboratory DirectorIlena Gonzalez
Laboratory Phone(813) 888-8215
Laboratory LocationCarrollwood Medical Group10213 Lake Carroll Way Ste D, Tampa, FL 33615
CLIA data matches this NPI record on: 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 Carrollwood Medical Group, LLC.'s NPI number?

The NPI number for Carrollwood Medical Group, LLC. is 1982150348. It was assigned to this organization in the NPPES registry on August 26, 2016. The provider is doing business as Revello Medical Center.

Where is Carrollwood Medical Group, LLC. located?

Carrollwood Medical Group, LLC. is located at 10213 Lake Carroll Way Ste B, Tampa, FL 33618. The listed phone number is (813) 888-8215.

What is Carrollwood Medical Group, LLC.'s specialty?

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

Does Carrollwood Medical Group, LLC. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2118999) is associated with this NPI, valid through September 18, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Carrollwood Medical Group, LLC. was last updated on February 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.