Organization
LAKELAND SURGICAL & DIAGNOSTIC CENTER LLP
Active
Other names
GRIFFIN RD CAMPUS OF LSDC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EMILY DUNCAN (CEO)
(863) 683-2428
Entity
Organization
Contact information
Practice address
818 GRIFFIN RD, LAKELAND, FL 33805-2440
(863) 687-0566
(863) 616-9289
Mailing address
115 S MISSOURI AVE, STE 101, LAKELAND, FL 33815-4600
(863) 683-2428
(863) 686-9873
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1213
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014447700
—
FL
01
—
10111447AC17
BEECHSTREET CDPHP
FL
01
—
490003123
RR MEDICARE
FL
01
—
6H3
BCBS
FL
Enumeration date
01/11/2007
Last updated
03/18/2016
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