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Organization

CAPERNAUM MEDICAL CENTER FOR KIDS PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ERIC ROBERTO VERNIER MD (MD/PRESIDENT)
(863) 232-4323
Entity
Organization

Contact information

Practice address
5129 S. LAKLAND DRIVE, SUITE 1, LAKELAND, FL 33813-2599
(863) 232-4323
(863) 337-5728
Mailing address
5129 S LAKELAND DR STE 1, LAKELAND, FL 33813-2599
(863) 232-4323
(863) 337-5728

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
019415800
FL
Enumeration date
10/11/2018
Last updated
10/11/2018
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