Organization
POLK CORRECTIONAL INSTITUTION
Active
Other names
Florida Department of Corrections
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LONG N DO MD (CHIEF HEALTH OFFICER)
(863) 984-2273
Entity
Organization
Contact information
Practice address
10800 EVANS RD, POLK CITY, FL 33868-6925
(863) 984-2273
(863) 984-1021
Mailing address
1531 MCCREA DR, LUTZ, FL 33549-3583
(863) 984-2273
(863) 984-1021
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
PA9100731
FL
Other
Enumeration date
01/08/2013
Last updated
01/08/2013
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