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

Dr. Luis Clyde Favilli, MD

Individual provider Family Medicine Physician · NPI 1013912625

Dr. Luis Clyde Favilli, MD is a Family Practice in Lakeland, Florida. Qualified in 1985, 41 years ago. Practices with Medical Home Alliance, LLC, a 63-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
41
Licensed in
FL
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3650 Innovation Dr
Lakeland, FL 33812-4105
Phone: (860) 709-1968
Fax: (863) 701-2151
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence ME56610 (FL)

Record details

NPI number1013912625
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJune 20, 2005
Last updated in NPPESMay 30, 2023
Certification dateMay 30, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 1985 (41 years in practice)
Group practice Medical Home Alliance, Llc — 63 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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