Individual
LIDZOE CORREA- MATEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5985 S FLORIDA AVE, LAKELAND, FL 33813-2533
(863) 644-8459
Mailing address
5985 S FLORIDA AVE, LAKELAND, FL 33813-2533
(863) 644-8459
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
17095
PR
208D00000X
General Practice Physician
Primary
ACN895
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ACN895
FLORIDA LICENSE
FL
Enumeration date
04/15/2008
Last updated
05/07/2024
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