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Organization
LWR FAMILY PRACTICE WALK-IN PL
Active
Organization
LWR FAMILY PRACTICE WALK-IN PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY MOTT (PA-C)
(941) 896-3900
Entity
Organization
Contact information
Practice address
8431 HERITAGE GREEN WAY, LAKEWOOD RANCH, FL 34212-1400
(941) 896-3900
(941) 896-3901
Mailing address
8431 HERITAGE GREEN WAY, LAKEWOOD RANCH, FL 34212-1400
(941) 896-3900
(941) 896-3901
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PA9101315
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DR744A
PTAN
FL
01
—
DW3053
PTANRR
FL
01
—
PA9101315
FLORIDA LICENSE NUMBER
FL
Enumeration date
05/02/2010
Last updated
01/22/2026
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