Organization
MY DOCTORS LIVE NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL V OLLIVIERRE-AGARD MD (OWNER)
(800) 838-8840
Entity
Organization
Contact information
Practice address
170 FITZGERALD RD STE 1, LAKELAND, FL 33813-2633
(800) 838-8840
Mailing address
170 FITZGERALD RD STE 1, LAKELAND, FL 33813-2633
(800) 838-8840
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
—
—
208D00000X
General Practice Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
07/08/2021
Last updated
08/01/2022
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