Southside Medical Clinic

LBN: Southside Medical Clinic
Southside Medical Clinic is an health care organization with primary practice located at 1707 E Edgewood Dr , Lakeland FL 33803-3470. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Southside Medical Clinic can be contacted via phone (863) 688-9219, or through Suares, Roger David via phone (863) 688-9219.

Contact Information

Primary practice address
1707 E Edgewood Dr Lakeland FL 33803-3470
Phone: (863) 688-9219
Fax: (863) 687-4863
Website:
Map and Directions
Authorized official contact:
Name: Suares, Roger David Doctor of Medicine (MD)
Phone: (863) 688-9219

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X ME0043239 Florida

Profile Details

NPI number 1356681845
LBN Legal business name Southside Medical Clinic
DBA Doing business as
Authorized official Suares, Roger David Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 21st, 2013
Last updated Feb 21st, 2013 - about 13 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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