Organization
MARI C FIELDING MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARI CHARLENE FIELDING MD (PRESIDENT)
(863) 616-9017
Entity
Organization
Contact information
Practice address
2720 NEVADA RD, LAKELAND, FL 33803
(863) 668-8215
(863) 682-4677
Mailing address
PO BOX 425, LAKELAND, FL 33803
(863) 616-9017
(863) 682-4677
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME0066256
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25369
BCBS
—
05
—
263832101
—
FL
01
—
K0883
MEDICARE LEGACY PROVIDER#
FL
Enumeration date
08/03/2006
Last updated
02/07/2011
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