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Organization
LAKEWOOD RANCH PRIMARY CARE LLC
Active
Organization
LAKEWOOD RANCH PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARVEY S. MISHNER M.D. (PARTNER)
(941) 907-0588
Entity
Organization
Contact information
Practice address
8340 LAKEWOOD RANCH BLVD, SUITE 350, LAKEWOOD RANCH, FL 34202-5180
(941) 907-0588
(941) 373-6622
Mailing address
8340 LAKEWOOD RANCH BLVD, SUITE 350, LAKEWOOD RANCH, FL 34202-5180
(941) 907-0588
(941) 373-6622
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34586
BCBS
FL
01
—
DA1812
MCR RR
FL
Enumeration date
04/19/2006
Last updated
04/20/2008
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