| |
550 Pope Ave Nw, Winter Haven, FL 33881-4679 | |
(863) 299-2636 | |
(863) 662-5288 |
Full Name | |
---|---|
Type | Facility |
Speciality | Family Medicine |
Location | 550 Pope Ave Nw, Winter Haven, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1356374466 | NPI | - | NPPES |
660109000 | Medicaid | FL | |
66010901 | Other | FL | MEDICAID |
253818100 | Other | FL | MEDICAID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Secondary |
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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550 Pope Ave Nw, Winter Haven, FL 33881-4679 Ph: (863) 299-2636 | 550 Pope Ave Nw, Winter Haven, FL 33881-4679 Ph: (863) 299-2636 |