Lake Wales Medical Walk In Clinic Pa

LBN: Lake Wales Medical Walk In Clinic Pa
Lake Wales Medical Walk In Clinic Pa is an health care organization with primary practice located at 1611 State Road 60 E , Lake Wales FL 33853-4309. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Lake Wales Medical Walk In Clinic Pa can be contacted via phone (863) 676-6007, or through Allen, Susan via phone (863) 676-6007.

Contact Information

Primary practice address
1611 State Road 60 E Lake Wales FL 33853-4309
Phone: (863) 676-6007
Fax: (863) 676-7659
Website:
Map and Directions
Authorized official contact:
Name: Allen, Susan
Phone: (863) 676-6007

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME87271 Florida

Profile Details

NPI number 1336196278
LBN Legal business name Lake Wales Medical Walk In Clinic Pa
DBA Doing business as
Authorized official Allen, Susan
Entity Organization
Organization subpart 1 No
Enumeration date May 27th, 2006
Last updated Feb 6th, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336196278 NPPES
Florida MEDICAID 265413000
Florida Other 97246
Florida Other 159572100
Florida Other 000005600
Florida Other 3499276

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