Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Palm Medical Center Lakeland LLC

Organization General Practice Physician · NPI 1073249348

Palm Medical Center Lakeland LLC is a General Practice Physician in Tampa, Florida. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11017 N Dale Mabry Hwy Ste B
Tampa, FL 33618-3873
Phone: (813) 337-7402
Fax: (813) 461-6462
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X
Clinic/Center Taxonomy 261Q00000X

Record details

NPI number1073249348
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Santiago Moises Martin — President Of Center Operations · (305) 913-9441
NPI enumeratedJuly 28, 2022
Last updated in NPPESJuly 28, 2022
Certification dateJuly 28, 2022
Mailing address2600 S Douglas Rd Ste 308, Coral Gables, FL 33134-6134

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