Unknown Individual – Family Medicine Physician, NPI 1154319614
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Golfview Avenue, Bartow, Polk County, Florida, 33830, United States
ATTN: BILLING DEPARTMENT 4TH FLOOR
BARTOW, FL 338306738
Phone: (863) 519-7900
Fax: (863) 519-7696
Type: Mailing
3241, Lakeland Hills Boulevard, Lakeland, Polk County, Florida, 33805, United States
LAKELAND, FL 338052266
Phone: (863) 413-2620
Fax: (863) 499-2612
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33830)
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