Organization
CANNACARE MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOCELYN GRACE EDMUNDSON (OFFICE MANAGER)
(918) 914-0895
Entity
Organization
Contact information
Practice address
1046 S FLORIDA AVE, LAKELAND, FL 33803-1118
(800) 201-3624
Mailing address
2137 SANDY HOOK, LAKELAND, FL 33813-1350
(918) 914-0895
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
01/03/2022
Last updated
01/03/2022
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