Individual
MRS. AYANNA AMLAK JOSEPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2625 S FLORIDA AVE, LAKELAND, FL 33803-3860
(863) 284-5941
(863) 284-5199
Mailing address
1324 LAKELAND HILLS BLVD, ATTN: MEDICAL STAFF OFFICE, LAKELAND, FL 33805-4543
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME123016
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/02/2012
Last updated
08/03/2015
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