PEDIM OUTREACH AND SPECIALTY CLINIC LLC – NPI #1558128819
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.

PEDIM OUTREACH AND SPECIALTY CLINIC LLC is a provider located in LECANTO, FL. NPPES has assigned the NPI number 1558128819 to PEDIM OUTREACH AND SPECIALTY CLINIC LLC on March 04, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was last updated on Feb 13, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PEDIM OUTREACH AND SPECIALTY CLINIC LLC below.

NPI Profile for
PEDIM OUTREACH AND SPECIALTY CLINIC LLC

NPI Number
1558128819
Enumeration Date

(more than 2 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PEDIM OUTREACH AND SPECIALTY CLINIC LLC
Primary location
2805 W FLARE LN
LECANTO, FL 34461
Phone: (352) 527-6888 Fax:
Mailing address
PO BOX 2066
LECANTO, FL 34460-2066
Phone: (352) 634-8736 Fax:
Organization Subpart
No
Authorized Official
DACELIN ST MARTIN
OWNER
Phone: (352) 527-6888
Updated
Certification Date
Feb 13, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.