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Organization

LAKE WALES PRIMARY CARE CENTER, LLC

Active
Parent organization
MEDICAL CARE CENTERS
Organization subpart
Yes

Provider details

NPI number
Legal business name
MEDICAL CARE CENTERS
Authorized official
MISS NAMRATA A. AMIN (CHIEF OPERATING OFFICER)
(727) 251-1366
Entity
Organization

Contact information

Practice address
1120 CARLTON AVE, SUITE 2300, LAKE WALES, FL 33853-4348
(727) 251-1366
(813) 968-5306
Mailing address
6916 W LINEBAUGH AVE, SUITE 101, TAMPA, FL 33625-5815
(727) 251-1366
(813) 968-5306

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
06/26/2008
Last updated
04/27/2009
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