Organization
LAKELAND ALLERGY ASTHMA & IMMUNOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN D CONVERS MD (SOLE MEMBER)
(305) 318-6096
Entity
Organization
Contact information
Practice address
4325 HIGHLAND PARK BLVD, LAKELAND, FL 33813-1671
(305) 318-6096
Mailing address
4325 HIGHLAND PARK BLVD, LAKELAND, FL 33813-1671
(863) 213-1010
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
—
Other
Enumeration date
03/06/2019
Last updated
04/04/2019
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