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Organization
LAKE WALES FOOT AND ANKLE CARE, INC
Active
Organization
LAKE WALES FOOT AND ANKLE CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRERNA ALFA MALL DPM (PRESIDENT)
(863) 676-1710
Entity
Organization
Contact information
Practice address
408 S 1ST ST, HIGHLAND MEADOWS, LAKE WALES, FL 33853-4146
(863) 676-1710
Mailing address
801 WOODLARK DR, HIGHLAND MEADOWS, HAINES CITY, FL 33844-7745
(863) 676-1710
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
05/18/2016
Last updated
09/26/2016
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