# MARI C FIELDING MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851309298
- **Authorized official:** DR. MARI CHARLENE FIELDING MD (PRESIDENT)
- **Authorized official phone:** (863) 616-9017

## Contact information

- **Practice address:** 2720 NEVADA RD, LAKELAND, FL 33803
- **Practice address phone:** (863) 668-8215
- **Practice address fax:** (863) 682-4677
- **Mailing address:** PO BOX 425, LAKELAND, FL 33803
- **Mailing address phone:** (863) 616-9017
- **Mailing address fax:** (863) 682-4677

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | ME0066256 | FL | Yes |

## Other

- **Enumeration date:** 08/03/2006
- **Last updated:** 02/07/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 25369 | BCBS | — |
| 05 | — | 263832101 | — | FL |
| 01 | — | K0883 | MEDICARE LEGACY PROVIDER\# | FL |