Organization

Lake Wales Primary Care Center, Llc

Specialist in Lake Wales, FL(View on Map)

Legal Business Name

Lake Wales Primary Care Center, Llc

NPI Number

1750543344

NPI Type

Organization

Enumeration Date

06/26/2008

Specialties

(Taxonomies)

Code

174400000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

6916 W LINEBAUGH AVE
1120 CARLTON AVE

City

Tampa
Lake Wales

State

FL
FL

Postal Code

33625-5815
33853-4348

Country

US
US

Telephone Number

(727) 251-1366
(727) 251-1366

Authorized Official

Name

Miss Namrata Amin

Title or Position

CHIEF OPERATING OFFICER

Telephone Number

(727) 251-1366

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 04/27/2009

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