Organization
FAMILY PRACTICE-ST CLOUD, INC.
Active
Other names
ProHealth Family Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN FREDERICK WILKER MD (PRESIDENT)
(407) 892-0009
Entity
Organization
Contact information
Practice address
3100 17TH ST, SAINT CLOUD, FL 34769-6021
(407) 892-0009
(407) 892-3285
Mailing address
3100 17TH ST, SAINT CLOUD, FL 34769-6021
(407) 892-0009
(407) 892-3285
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME0036943
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34984
BLUE CROSS BLUE SHEILD
FL
Enumeration date
06/08/2006
Last updated
02/06/2023
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