Organization
MEDICAL VENTURES OF AMERICA
Active
Other names
LAKE REGIONAL URGENT CARE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DAWN E WALKER (DIRECTOR OF BILLING)
(352) 315-1651
Entity
Organization
Contact information
Practice address
910 OLD CAMP RD, PROF BLDG 114, THE VILLAGES, FL 32162-5604
(352) 259-4322
(352) 259-3882
Mailing address
910 OLD CAMP RD, PROF BUILDING 114, THE VILLAGES, FL 32162
(352) 315-8881
(352) 315-8883
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B902B
BLUE CROSS AND BLUE SHIEL
FL
Enumeration date
07/17/2007
Last updated
07/17/2007
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