| Polk County Board Of County Commissioners (polk County Bocc) | |
|
2120 Marshall Edwards Dr Bartow FL 33830-6731 | |
| (863) 519-7579 | |
| (863) 519-4783 |
| Full Name | Polk County Board Of County Commissioners (polk County Bocc) |
|---|---|
| Speciality | General Practice |
| Location | 2120 Marshall Edwards Dr, Bartow, Florida |
| Authorized Official Name and Position | Samuel (sam) Johnson (CHAIRMAN) |
| Authorized Official Contact | 8635346049 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Polk County Board Of County Commissioners (polk County Bocc) 2135 Marshall Edwards Dr Bartow FL 33830-6757 Ph: (863) 519-7579 | Polk County Board Of County Commissioners (polk County Bocc) 2120 Marshall Edwards Dr Bartow FL 33830-6731 Ph: (863) 519-7579 |
| NPI Number | 1154462703 |
|---|---|
| Provider Enumeration Date | 02/08/2007 |
| Last Update Date | 04/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154462703 | NPI | - | NPPES |
| 010168101 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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