Lake Wales Physician Services, Llc

LBN: Lake Wales Physician Services, Llc
Lake Wales Physician Services, Llc is an health care organization with primary practice located at 410 S 11Th St , Lake Wales FL 33853-4203. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Allopathic & Osteopathic Physicians / Hospitalist is the primary health care specialty. Lake Wales Physician Services, Llc can be contacted via phone (863) 676-1433, or through Falk, Lisha C via phone (337) 609-1221.

Contact Information

Primary practice address
410 S 11Th St Lake Wales FL 33853-4203
Phone: (863) 676-1433
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Falk, Lisha C
Phone: (337) 609-1221

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X

Profile Details

NPI number 1164902797
LBN Legal business name Lake Wales Physician Services, Llc
DBA Doing business as
Authorized official Falk, Lisha C
Entity Organization
Organization subpart 1 No
Enumeration date Aug 14th, 2018
Last updated Mar 23rd, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164902797 NPPES
Florida MEDICAID 101044600

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