NPI | 1063858538 |
---|---|
Doing Business As | LAKE MIRIAM CAMPUS |
Entity Type | Organization |
Authorized Contact | LANCE GREEN VP/CFO 863-687-1100 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine |
208D00000X General Practice | |
363LF0000X Nurse Practitioner, Family | |
207Q00000X Family Medicine | |
207R00000X Internal Medicine | |
Enumeration Date | 2013-05-10 |
Last Update Date | 2023-01-24 |