Four Corners Medical Center, LLC is a Clinic/Center (organization) practicing in Davenport, Florida. The National Provider Identifier (NPI) is #1295678605, which was assigned on April 10, 2026, and the registration record was last updated on April 10, 2026. The practitioner's main practice location is at 106 Polo Park East Blvd, Davenport, FL 33897-9407; the contact telephone number is 8634248900, and the fax number is 8634248823. The primary taxonomy of Four Corners Medical Center, LLC is Clinic/Center (261Q00000X). The authorized official for Four Corners Medical Center, LLC is Dr. Srinath R Kosanam (President-Owner).
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
| NPI | 1295678605 |
| Entity Type | Organization |
| Organization Name | FOUR CORNERS MEDICAL CENTER, LLC |
| Provider Name | FOUR CORNERS MEDICAL CENTER, LLC |
| Practice Address |
106 Polo Park East Blvd Davenport FL 33897-9407 |
| Practice Telephone | 8634248900 |
| Practice Fax Number | 8634248823 |
| Mailing Address |
10603 Emerald Chase Dr Orlando FL 32836-5855 |
| Mailing Telephone | 4078447323 |
| Mailing Fax Number | 8634248823 |
| Certification Date | 2026-04-10 |
| Enumeration Date | 2026-04-10 |
| Last Update Date | 2026-04-10 |
| Is Organization Subpart | N |
| Official Name | DR. SRINATH R KOSANAM |
| Official Title | PRESIDENT-OWNER |
| Credential | MD |
| Telephone | 4078447323 |
| Primary | Code | Classification | Specialization | Taxonomy Group | License Number | License State |
|---|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center |
| Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| Classification | Clinic/Center |
| Grouping | Ambulatory Health Care Facilities |
| Definition: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Mobe, LLC | 3701 Wayzata Blvd Ste 450, Minneapolis, MN 55416-0018 | Clinic/Center | 2026-04-10 |
| Crown of Healing LLC | 623 Northview Dr, Pineville, LA 71360-4167 | Clinic/Center | 2026-04-09 |
| Novaheal Wound Center Inc | 16501 Ventura Blvd Ste 465, Encino, CA 91436-2007 | Clinic/Center | 2026-04-09 |
| Healingly LLC | 2014 W Pinhook Rd, Lafayette, LA 70508-8504 | Clinic/Center | 2026-04-11 |
| Asa Acupuncture & Integrative Medicine | 440 Cobia Dr Ste 1901, Katy, TX 77494-7139 | Clinic/Center | 2026-04-09 |
| Walk-In and Intermediate Care Clinic | 214 S Mccleskey St Ste 857, Boaz, AL 35957-2187 | Clinic/Center | 2026-04-10 |
| Usk Management Corporation | 150 River St Apt 252, Hackensack, NJ 07601-5638 | Clinic/Center | 2026-04-06 |
| Vivavida Medical Group LLC | 2121 E Flamingo Rd Ste 200a, Las Vegas, NV 89119-5124 | Clinic/Center | 2026-04-10 |
| Blooming Bellies Doula Services LLC | 2632 S 83rd Ave Ste 100183, Phoenix, AZ 85043-7206 | Clinic/Center | 2026-04-10 |
| One Health Solutions LLC | 433 N 9th St, Fredonia, KS 66736-1423 | Clinic/Center | 2026-04-09 |
| Find all providers with the same taxonomy | |||
| Street Address |
106 POLO PARK EAST BLVD |
| City | DAVENPORT |
| State | FL |
| Zip Code | 33897-9407 |
| Country | US |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Srinath Reddy Kosanam | 106 Polo Park East Blvd, Davenport, FL 33897-9407 | Internal Medicine Physician | 2005-08-22 |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Isa Betancourt Reyes | 190 Champions Vue Loop Unit 412, Davenport, FL 33897-4857 | Speech-Language Pathologist | 2025-08-18 |
| Holly Gibbons Lmhc LLC | 345 Samuel St, Davenport, FL 33897-6218 | Mental Health Clinic/Center (Including Community Mental Health Center) | 2025-11-20 |
| Natasia C Lindsay | 1204 Fan Palm Dr, Davenport, FL 33897-5738 | Family Nurse Practitioner | 2025-11-22 |
| Miguel A Yrigoyen | 2611 Bimini Bay Cres Unit 105, Davenport, FL 33897-1783 | Behavior Technician | 2026-02-25 |
| Andrea G Aviles Calderon | 271 Williamson Dr, Davenport, FL 33897-6292 | Family Nurse Practitioner | 2026-03-18 |
| Ana Leonor Santoya | 1306 Fan Palm Dr, Davenport, FL 33897-5740 | Behavior Technician | 2025-11-24 |
| Nelson Antonio Nieves | 45669 Highway 27, Davenport, FL 33897-4546 | Family Medicine Physician | 2007-02-27 |
| Yilena Sablon Hormigo | 3838 Marbella Way, Davenport, FL 33897-3631 | Behavior Technician | 2025-09-29 |
| Losemica Eiliassaint | 2500 Berry Blvd, Davenport, FL 33897-3800 | Primary Care Nurse Practitioner | 2025-09-10 |
| Yoladis R Abreu | 162 Verona Pl, Davenport, FL 33897-7463 | Behavioral Analyst | 2019-05-20 |
| Find all providers in the same zip code | |||
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Five Corners Physical Therapy S.C. | 7269 State Road 60, Suite 1, Cedarburg, WI 53012-9702 | Physical Therapist | 2007-01-31 |
| Four Corners Medical Supply | 1050 Us Highway 27, Suite 20, Clermont, FL 34714-7508 | Durable Medical Equipment & Medical Supplies | 2006-07-09 |
| Five Corners Pharmacy Services | 8404 Bowdoin Way, Ste B, Edmonds, WA 98026-7322 | Community/Retail Pharmacy | 2006-09-06 |
| Hearth At Four Corners | 16 Ronald St, Dorchester, MA 02121-3646 | Adult Day Care Clinic/Center | 2025-01-22 |
| Hales Corners Care and Rehab Center LLC | 9449 W Forest Home Ave, Hales Corners, WI 53130-1611 | Skilled Nursing Facility | 2025-04-04 |
| Four Corners Foot and Ankle P.C. | 2700 Farmington Ave Bldg C, Ste 1, Farmington, NM 87401-4550 | Durable Medical Equipment & Medical Supplies | 2014-06-11 |
| Three Corners Counseling | 40 Triple Oak Dr, Candler, NC 28715-9323 | Addiction (Substance Use Disorder) Counselor | 2025-10-23 |
| Four Corners Ob/Gyn | 1 Mercado St, Suite # 105, Durango, CO 81301-7300 | Specialist | 2006-08-31 |
| Four Corners Foot and Ankle PC | 1266 Escalante Dr Ste 201, Durango, CO 81303-8934 | Durable Medical Equipment & Medical Supplies | 2021-12-30 |
| Trc - Four Corners Dialysis Clinics LLC | 801 W Broadway, Farmington, NM 87401-5650 | End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 2006-04-18 |
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This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.
| Subject | Transparency and Disclosure |
| Jurisdiction | Federal |
| Data Provider | National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS) |
| Source | download.cms.gov |
The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid). Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008. This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information. |