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1013912625
LUIS CLYDE FAVILLI
LAKELAND, FL
NPI
1013912625
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: FL ME56610)
Enumeration Date
2005-06-20
Last Update Date
2023-05-30
Business Address
Dr. LUIS CLYDE FAVILLI MD
3650 INNOVATION DR
LAKELAND, FL 33812-4105
Phone number: 860-709-1968
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Mailing Address
Dr. LUIS CLYDE FAVILLI MD
6675 WESTWOOD BLVD STE 475
ORLANDO, FL 32821-6027
Phone number: 407-845-0330
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