Organization
PALM MEDICAL CENTER LAKELAND LLC
Active
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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