Luis Clyde Favilli in Lakeland - Family Medicine
Luis Clyde Favilli - NPI 1013912625
Luis Clyde Favilli is a Family Medicine in Lakeland, Florida. Luis Clyde Favilli practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Luis Clyde Favilli is 1013912625. The last update date is 2023-05-30.
Luis Clyde Favilli's current location address is 3650 Innovation Dr, Lakeland, Florida. You can contact this provider via phone number 8607091968 and fax number 8637012151. The mailing address for Luis Clyde Favilli is 3650 Innovation Dr, Lakeland, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Luis Clyde Favilli |
|---|---|
| Address | 3650 Innovation Dr, Lakeland, Florida |
| Phone Number | 8607091968 |
| Fax Number | 8637012151 |
| Sole Proprietor | Y |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1013912625 |
|---|---|
| Provider Enumeration Date | 2005-06-20 |
| Last Updated Date | 2023-05-30 |
Provider Mailing Address Detail
| Address | 3650 Innovation Dr |
|---|---|
| City | Lakeland |
| State | Florida (FL) |
| Post Code | 3381241050 |
| Phone Number | 8607091968 |
| Fax Number | 8637012151 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | ME56610 |
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Definition: 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 i |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 374563500 | FL | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Luis Clyde Favilli by the Centers for Medicare & Medicaid Services?
The Luis Clyde Favilli has been issued the NPI (National Provider Identifier) 1013912625, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Luis Clyde Favilli is physically located?
The Luis Clyde Favilli is situated at the following address: 3650 Innovation Dr, Lakeland, FL 3381241050.
What is the Luis Clyde Favilli's specialty and taxonomy code?
The Luis Clyde Favilli's specialty is Family Medicine, and the corresponding taxonomy code is 207Q00000X.
On what date was the 1013912625 assigned to Luis Clyde Favilli?
The Luis Clyde Favilli was issued its 1013912625 on 2005-06-20, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Luis Clyde Favilli last refreshed?
The information related to the Luis Clyde Favilli, including its address, specialty, and other relevant details, was last updated on 2023-05-30.
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