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Organization
PARK LAKE PHYSICAL MEDICINE, LLC
Active
Organization
PARK LAKE PHYSICAL MEDICINE, LLC
Active
Other names
Integrative Physical Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHELBY ANNE REID (MANAGER)
(407) 839-1045
Entity
Organization
Contact information
Practice address
2206 E COLONIAL DR, ORLANDO, FL 32803-4912
(407) 839-1045
(407) 839-1044
Mailing address
2206 E COLONIAL DR, ORLANDO, FL 32803-4912
(407) 839-1045
(407) 839-1044
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
11/23/2011
Last updated
03/19/2014
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