SOUTHSIDE MEDICAL CLINIC is a clinic center in Lakeland, FL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). SOUTHSIDE MEDICAL CLINIC NPI is 1356681845. The provider is registered as an organization entity type.
The provider's business location address is:
1707 E EDGEWOOD DR
LAKELAND, FL
ZIP 33803-470
Phone: (863) 688-9219
Fax: (863) 687-4863
The provider's authorized official is Roger David Suares .
The authorized official title is Medical Director and has the following contact phone number (863) 688-9219.
The CLIA number assigned to this NPI record is 10D0888769 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 2/21/2013 and was last updated on 2/21/2013.