is a Ambulatory Surgical in Lakeland, Florida. practices all healthcare services and medical treatments related to Ambulatory Surgical. The NPI Number for is 1962552232. The last update date is .
's current location address is 818 Griffin Rd, Lakeland, Florida. You can contact this provider via phone number 8636870566 and fax number 8636169289. The mailing address for is 818 Griffin Rd, Lakeland, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 818 Griffin Rd, Lakeland, Florida |
| Phone Number | 8636870566 |
| Fax Number | 8636169289 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1962552232 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 818 Griffin Rd |
|---|---|
| City | Lakeland |
| State | Florida (FL) |
| Post Code | 338052440 |
| Phone Number | 8636870566 |
| Fax Number | 8636169289 |
Provider's Primary Taxonomy Detail
| Speciality | Ambulatory Surgical |
|---|---|
| Taxonomy | 261Qa1903X |
| Licence No | 1213 |
|
Definition: Provides outpatient surgical services not requiring hospitalization. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 14447700 | FL | -- | |
| 6H3 | FL | BCBS | |
| 10111447AC17 | FL | BEECHSTREET CDPHP | |
| 490003123 | FL | RR MEDICARE |
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