Organization
VA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VETA SHANTAYE KEYS (RN/EMERGENCY NURSING)
(863) 602-4131
Entity
Organization
Contact information
Practice address
5416 ORANGE VALLEY DR, LAKELAND, FL 33813-2649
(863) 602-4131
Mailing address
5416 ORANGE VALLEY DR, LAKELAND, FL 33813-2649
(863) 602-4131
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
RN9257726
FL
286500000X
Military Hospital
RN202364
GA
Other
Enumeration date
09/30/2009
Last updated
09/30/2009
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