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Organization
MEDICAL HOME ALLIANCE LLC
Active
Organization
MEDICAL HOME ALLIANCE LLC
Active
Parent organization
MEDICAL HOME ALLIANCE LLC
Other names
IMA Medical Group - South Lakeland
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDICAL HOME ALLIANCE LLC
Authorized official
VANESSA HOURIHAN (VP REVENUE CYCLE)
(321) 394-5736
Entity
Organization
Contact information
Practice address
4729 US HIGHWAY 98 S STE 201, LAKELAND, FL 33812-4336
(863) 940-3147
(863) 940-3141
Mailing address
6675 WESTWOOD BLVD STE 475, ORLANDO, FL 32821-6027
(407) 845-0330
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
08/27/2021
Last updated
12/05/2023
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