Organization
PRESTIGE COMMUNITY CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANN VIOLET LOCKHART (CHAIRMAN /REGISTERED AGENT)
(407) 535-3857
Entity
Organization
Contact information
Practice address
110 W 7TH ST, LAKELAND, FL 33805-4813
(407) 535-3857
(239) 302-1344
Mailing address
579 FINCH CT, KISSIMMEE, FL 34759-4426
(407) 535-3857
(239) 302-1344
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Enumeration date
03/31/2017
Last updated
03/31/2017
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