Organization
PALM MEDICAL CENTER LAKELAND LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FOWAD CHOUDHRY (COO)
(786) 814-4790
Entity
Organization
Contact information
Practice address
116 W BOUGAINVILLEA AVE, TAMPA, FL 33612-7437
(813) 932-4381
Mailing address
2600 S DOUGLAS RD STE 308, CORAL GABLES, FL 33134-6134
(786) 814-4790
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
12/22/2020
Last updated
12/22/2020
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