Organization
DEMETRA BENNETT ARNP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEMETRA BENNETT ARNP (OWNER)
(352) 585-0768
Entity
Organization
Contact information
Practice address
3628 HARDEN BLVD, LAKELAND, FL 33803-5938
(863) 701-2225
Mailing address
3628 HARDEN BLVD, LAKELAND, FL 33803-5938
(863) 701-2225
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
9164847
FL
Other
Enumeration date
04/25/2010
Last updated
04/25/2010
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