Organization
VASCULAR SPECIALISTS OF LAKELAND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD J GOODEMOTE PHD, RN (CEO)
(863) 688-2334
Entity
Organization
Contact information
Practice address
2125 CRYSTAL GROVE DR, LAKELAND, FL 33801-6875
(863) 688-2334
(863) 577-1167
Mailing address
2125 CRYSTAL GROVE DR, LAKELAND, FL 33801-6875
(863) 688-2334
(863) 577-1167
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
04/09/2012
Last updated
08/12/2013
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