Organization
LAKESIDE PEDIATRICS SOUTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW J CORY MD (PARTNER)
(863) 688-3550
Entity
Organization
Contact information
Practice address
5950 S FLORIDA AVE, LAKELAND, FL 33813-2532
(863) 619-8441
(863) 646-6579
Mailing address
5950 S FLORIDA AVE, LAKELAND, FL 33813-2532
(863) 619-8441
(863) 646-6579
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251933001
—
FL
Enumeration date
07/31/2006
Last updated
05/29/2015
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