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Organization
EXPRESS CARE OF LAKE COUNTY LLC
Active
Organization
EXPRESS CARE OF LAKE COUNTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY T JACKSON DO (MEDICAL DIRECTOR)
(352) 742-1500
Entity
Organization
Contact information
Practice address
2020 NIGHTINGALE LN, TAVARES, FL 32778-4361
(352) 742-1500
(352) 742-2530
Mailing address
2020 NIGHTINGALE LN, TAVARES, FL 32778-4361
(352) 742-1500
(352) 742-2530
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS11411
FL
Other
Enumeration date
09/11/2014
Last updated
11/15/2016
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