Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
LAKE WALES MEDICAL WALK IN CLINIC PA
Active
Organization
LAKE WALES MEDICAL WALK IN CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN ALLEN (OFFICE MANAGER)
(863) 676-6007
Entity
Organization
Contact information
Practice address
1611 STATE ROAD 60 E, LAKE WALES, FL 33853-4309
(863) 676-6007
(863) 676-7659
Mailing address
1611 STATE ROAD 60 E, LAKE WALES, FL 33853-4309
(863) 676-6007
(863) 676-7659
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME87271
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000005600
HUMANA
—
01
—
159572100
DEPARTMENT OF LABOR OWCP
—
05
—
265413000
—
FL
01
—
3499276
AETNA HEALTH MGMT LLC
—
01
—
97246
BLUE CROSS BLUE SHEILD FL
FL
Enumeration date
05/27/2006
Last updated
02/06/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up