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Organization
LUIS C FAVILLI MD LLC
Active
Organization
LUIS C FAVILLI MD LLC
Active
Other names
FAVILLI FAMILY PRACTICE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS C FAVILLI MD (FAMILY PRACTICE)
(863) 285-7171
Entity
Organization
Contact information
Practice address
3650 INNOVATION DR, LAKELAND, FL 33812-4105
(863) 646-6295
(863) 701-2151
Mailing address
6675 WESTWOOD BLVD, STE 475, ORLANDO, FL 32821-8061
(407) 845-0330
(888) 972-1752
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME0056610
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E49325
—
FL
Enumeration date
11/27/2007
Last updated
04/27/2017
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