National Provider Identifier Database

MULTI SPECIALTY PRIMARY CARE PRACTICE GROUP OF LAKE WALES LLC
Specialist

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.


Contact Information

MULTI-SPECIALTY & PRIMARY CARE PRACTICE GROUP OF LAKE WALES LLC
1255 STATE ROAD 60 EAST
LAKE WALES, FL33853
Phone: 863-232-5111
Fax: 866-922-0875
Website:
Specialty Taxonomy Code
* Specialist 174400000X

* Indicates primary specialty

NPI Profile & details for MULTI-SPECIALTY & PRIMARY CARE PRACTICE GROUP OF LAKE WALES LLC

NPI Number 1467605634
Legal business name
LBN
MULTI-SPECIALTY & PRIMARY CARE PRACTICE GROUP OF LAKE WALES LLC
Authorized official KOLLAGUNTA CHANDRASEKHAR - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 10/31/2008
Last updated 04/08/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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