Individual
MRS. CLARITA SUYAT KETELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1600 LAKELAND HILLS BLVD, LAKELAND, FL 33805-3019
(863) 680-7000
(866) 264-8519
Mailing address
PO BOX 95004, LAKELAND, FL 33804-5004
(863) 680-7000
(866) 264-8519
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
CK008071
MI
207R00000X
Internal Medicine Physician
Primary
OS14099
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417975145
—
NV
05
—
1663975
—
MI
01
—
5500044
BCBS
MI
01
—
PR23457700001
CIGNA
MI
Enumeration date
07/18/2006
Last updated
07/21/2022
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