Unknown Individual – Family Medicine Physician, NPI 1205821287
Family Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
950 COUNTY ROAD 17A W
AVON PARK, FL 338252164
Phone: (863) 452-3060
Fax: (863) 452-3069
Type: Mailing
936, East Parker Street, Lakeland, Polk County, Florida, 33801, United States
LAKELAND, FL 338011968
Phone: (863) 413-8600
Fax: (863) 413-8650
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
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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 ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33825)
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