Organization
PHYSICIAN CONSULTANT ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANE PARKER (PRESIDENT)
(863) 299-2636
Entity
Organization
Contact information
Practice address
550 POPE AVE NW, WINTER HAVEN, FL 33881-4679
(863) 299-2636
(863) 662-5288
Mailing address
550 POPE AVE NW, WINTER HAVEN, FL 33881-4679
(863) 299-2636
(863) 662-5288
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
03/15/2017
Last updated
03/15/2017
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