MULTI-SPECIALTY & PRIMARY CARE PRACTICE GROUP OF LAKE WALES LLC is a specialist in Lake Wales, FL. The provider is 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. MULTI-SPECIALTY & PRIMARY CARE PRACTICE GROUP OF LAKE WALES LLC NPI is 1467605634. The provider is registered as an organization entity type and is a multi-specialty group.
The provider's business location address is:
1255 STATE ROAD 60 EAST
LAKE WALES, FL
ZIP 33853
Phone: (863) 232-5111
Fax: (866) 922-0875
The provider's authorized official is Kollagunta S Chandrasekhar .
The authorized official title is Owner and has the following contact phone number (863) 294-5505.
The enumeration date for this NPI number is 10/31/2008 and was last updated on 4/8/2009.