Organization
PALM MEDICAL CENTER LAKELAND LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANTIAGO MOISES MARTIN (PRESIDENT OF CENTER OPERATIONS)
(305) 913-9441
Entity
Organization
Contact information
Practice address
37235 MEDICAL DR, DADE CITY, FL 33525-5246
(352) 496-5823
(352) 345-4889
Mailing address
2600 S DOUGLAS RD STE 308, CORAL GABLES, FL 33134-6134
(813) 538-7880
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/11/2022
Last updated
08/11/2022
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