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

Mikhail Radivilov, MD

Individual provider Internal Medicine Physician · NPI 1720050966

Mikhail Radivilov, MD is an Internal Medicine in Lakeland, Florida. Qualified in 1981, 45 years ago. Practices with Watson Clinic LLP, a 362-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
45
Licensed in
FL
In the registry since
2006
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

1600 Lakeland Hills Blvd
Lakeland, FL 33805
Phone: (863) 680-7190
Fax: (866) 264-8519
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence ME75456 (FL)

Record details

NPI number1720050966
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedFebruary 2, 2006
Last updated in NPPESNovember 27, 2023
Certification dateSeptember 23, 2020
Mailing address1600 Lakeland Hills Blvd, Lakeland, FL 33805-3019

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 1981 (45 years in practice)
Group practice Watson Clinic Llp — 362 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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