Organization
BLUEBYRD WOUND AND LYMPHATIC CARE AND CONSULTATION SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY C MCINTYRE LPN (MANAGER)
(813) 683-2277
Entity
Organization
Contact information
Practice address
3374 WINCHESTER ESTATES CIR, LAKELAND, FL 33810-4364
(863) 509-8328
Mailing address
3374 WINCHESTER ESTATES CIR, LAKELAND, FL 33810-4364
(863) 509-8328
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
08/22/2023
Last updated
10/06/2023
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