LUIS C FAVILLI MD LLC (NPI# 1336321835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336321835 |
| Entity Type | Organization |
| Organization Name | LUIS C FAVILLI MD LLC |
| Other Organization Name | FAVILLI FAMILY PRACTICE CENTER |
| Practice Address |
3650 Innovation Dr Lakeland FL 33812-4105 |
| Mailing Address |
6675 Westwood Blvd Ste 475 Orlando FL 32821-8061 |
| Practice Telephone | 8636466295 |
| Practice Fax Number | 8637012151 |
| Mailing Telephone | 4078450330 |
| Mailing Fax Number | 8889721752 |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2017-04-27 |
| Authorized Official Name | DR. LUIS C FAVILLI (FAMILY PRACTICE) |
| Authorized Official Telephone | 8632857171 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | ME0056610 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | E49325 | 05 |
| Other Name | Type Code |
|---|---|
| FAVILLI FAMILY PRACTICE CENTER | Doing Business As Name - Organization |
| Street Address |
3650 INNOVATION DR |
| City | LAKELAND |
| State | FL |
| Zip Code | 33812-4105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013912625 | Luis Clyde Favilli | Family Medicine | 3650 Innovation Dr, Lakeland, FL 33812-4105 | 2005-06-20 |
| 1558543843 | Terrance S Delikat Do Pl | Family Medicine | 3650 Innovation Dr, Lakeland, FL 33812-4105 | 2007-11-29 |
| 1629134952 | Nancy Blas | General Practice | 3650 Innovation Dr, Lakeland, FL 33812-4105 | 2006-12-29 |
| 1811910060 | Joel David Gonzalez-mendez | General Practice | 3650 Innovation Dr, Lakeland, FL 33812-4105 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891036976 | Arlene Nitza Hunt | Counselor | 5421 Us Highway 98 S, Lakeland, FL 33812 | 2013-03-14 |
| 1952648867 | Christopher Benka | Pharmacist | 5185 Us Highway 98 S, Lakeland, FL 33812 | 2013-01-11 |
| 1407105083 | Elena Kan | Dentist | 5644 Vintage View Boulevard, Lakeland, FL 33812 | 2012-08-29 |
| 1760611412 | Blanca Lilia Fernandez | Dentist | 5163 Us Highway 98 S, Lakeland, FL 33812 | 2009-07-02 |
| 1033314190 | Gustavo Alberto De Jesus-gomez | Surgery | 5907 Hillside Heights Dr., Lakeland, FL 33812 | 2007-06-19 |
| 1760600142 | Internal Medicine Specialists Medical Group Pa | Internal Medicine | 3655 Innovation Dr, Lakeland, FL 33812 | 2007-04-23 |
| 1124171475 | Sports and Orthopedic Rehabilitation Services Inc | Clinic/Center | 5155 Us Highway 98 South, Suites 5b&5c, Lakeland, FL 33812 | 2007-01-19 |
| 1356322234 | Carlos M Romero | Family Medicine | 3655 Innovation Drive, Lakeland, FL 33812 | 2005-11-08 |
| 1427055318 | Roxann Castelli Cook | Family Medicine | 2803 Meridian Point Lane, Lakeland, FL 33812 | 2005-07-07 |
| 1316577513 | Ashley Joanne Reckord | Counselor | 5421 Us Highway 98 S, Lakeland, FL 33812 | 2020-01-16 |
| Find all providers in zip 33812 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174121909 | Amanda Millican | Family Medicine | 605 Laura Rd, Lakeland, FL 33815-3220 | 2020-10-14 |
| 1093320848 | Katrena Borders Flowers | Family Medicine | 2629 Highlands Creek Way, Lakeland, FL 33813-6301 | 2020-09-09 |
| 1578177523 | Robinson Family Clinic Inc | Family Medicine | 4406 S Florida Ave Ste 30, Lakeland, FL 33813-2176 | 2020-09-06 |
| 1306467311 | Christopher James Miller | Family Medicine | 215 S Elm Rd, Lakeland, FL 33801-2310 | 2020-04-30 |
| 1811480387 | Victoria Anne Morin | Family Medicine | 1463 Town Center Dr, Lakeland, FL 33803-7966 | 2018-06-10 |
| 1467890665 | Rachael Veronique Ollivierre-agard | Family Medicine | 170 Fitzgerald Rd Ste 1, Lakeland, FL 33813-2633 | 2013-06-10 |
| 1740587211 | Javier Andres Diago Benjumea | Family Medicine | 3015 Lakeland Highlands Rd, Lakeland, FL 33803-4339 | 2011-02-18 |
| 1891099792 | Sergio B Seoane Md Pa | Family Medicine | 118 Allamanda Sr, Lakeland, FL 33803 | 2011-01-06 |
| 1063673812 | Avantica Gondi | Family Medicine | 1818 Harden Blvd Ste 120, Lakeland, FL 33803-1813 | 2008-06-24 |
| 1942460902 | Michael Curtiss | Family Medicine | 2039 E Edgewood Dr, Suite B, Lakeland, FL 33803-3601 | 2008-06-12 |
| Find all providers in LAKELAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.