National Provider Identifier Database

PEDIM OUTREACH AND SPECIALTY CLINIC LLC
Internal Medicine

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.


Contact Information

PEDIM OUTREACH AND SPECIALTY CLINIC LLC
1982 N PROSPECT AVE
LECANTO, FL34461
Phone: 352-563-0931
Fax:
Website:
Specialty Taxonomy Code
* Internal Medicine 207R00000X
Durable Medical Equipment & Medical Supplies 332B00000X
Physical Therapy 261QP2000X
Sleep Disorder Diagnostic 261QS1200X
Sleep Medicine 207RS0012X
Sleep Medicine 207QS1201X

* Indicates primary specialty

NPI Profile & details for PEDIM OUTREACH AND SPECIALTY CLINIC LLC

NPI Number 1851848097
Legal business name
LBN
PEDIM OUTREACH AND SPECIALTY CLINIC LLC
Authorized official DACELIN ST MARTIN - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 09/06/2016
Last updated 05/06/2026 - About a month ago
Sole proprietor1 Not specified
Identifiers
  • FL Medicaid: 103596200

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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