| Lakeland Physicians & Associates, Llc | |
|
1818 Harden Blvd Ste 120 Lakeland FL 33803-1812 | |
| (863) 210-5640 | |
| (863) 210-5716 |
| Full Name | Lakeland Physicians & Associates, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1818 Harden Blvd, Lakeland, Florida |
| Authorized Official Name and Position | Jean Thomas (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 8632105640 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeland Physicians & Associates, Llc Po Box 470426 Lake Monroe FL 32747-0426 Ph: (863) 210-5640 | Lakeland Physicians & Associates, Llc 1818 Harden Blvd Ste 120 Lakeland FL 33803-1812 Ph: (863) 210-5640 |
| NPI Number | 1427429281 |
|---|---|
| Provider Enumeration Date | 10/19/2015 |
| Last Update Date | 01/19/2017 |
| Medicare PECOS PAC ID | 4183927577 |
|---|---|
| Medicare Enrollment ID | O20160119000951 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427429281 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Avantica Gondi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063673812 PECOS PAC ID: 3779623962 Enrollment ID: I20091219000053 |
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