Organization
PARK LAKE PHYSICAL MEDICINE, LLC
Active
Other names
Integrative Physical Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHELBY ANNE REID (MANAGER)
(407) 839-1045
Entity
Organization
Contact information
Practice address
2206 E COLONIAL DR, ORLANDO, FL 32803-4912
(407) 839-1045
(407) 839-1044
Mailing address
2206 E COLONIAL DR, ORLANDO, FL 32803-4912
(407) 839-1045
(407) 839-1044
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6694190001
DMERC
FL
Enumeration date
11/23/2011
Last updated
03/19/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us