Organization
LAKE WALES FOOT AND ANKLE CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRERNA ALFA MALL DPM (PRESIDENT)
(863) 676-1710
Entity
Organization
Contact information
Practice address
408 S 1ST ST, HIGHLAND MEADOWS, LAKE WALES, FL 33853-4146
(863) 676-1710
Mailing address
801 WOODLARK DR, HIGHLAND MEADOWS, HAINES CITY, FL 33844-7745
(863) 676-1710
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
05/18/2016
Last updated
09/26/2016
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