Individual
VANESSA L PROWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3525 LAKELAND HILLS BLVD, LAKELAND, FL 33805-1965
(863) 603-6565
Mailing address
1324 LAKELAND HILLS BLVD, ATTN: MANAGED CARE DEPT, LAKELAND, FL 33805-4543
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
ME115554
FL
2086X0206X
Surgical Oncology Physician
Primary
ME115554
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021561300
—
FL
Enumeration date
05/25/2010
Last updated
07/20/2022
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