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Organization
POLARIS MEDICAL GROUP PA
Active
Organization
POLARIS MEDICAL GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAISON JOSEPH LUKE APRN FNP-BC (VICE PRESIDENT)
(407) 729-4298
Entity
Organization
Contact information
Practice address
1705 LAKELAND HILLS BLVD STE 1, LAKELAND, FL 33805-3061
(863) 688-6051
(938) 336-2587
Mailing address
1705 LAKELAND HILLS BLVD STE 1, LAKELAND, FL 33805-3061
(863) 688-6051
(938) 336-2587
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/10/2024
Last updated
05/10/2024
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