| Florida Poly Tech | |
|
4700 Research Way Lakeland FL 33805-8531 | |
| (863) 603-6504 | |
| (863) 284-6824 |
| Full Name | Florida Poly Tech |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 4700 Research Way, Lakeland, Florida |
| Authorized Official Name and Position | Lance Green (VP/CFO) |
| Authorized Official Contact | 8636871100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Florida Poly Tech 1324 Lakeland Hills Blvd Lakeland FL 33805-4543 Ph: (863) 687-1100 | Florida Poly Tech 4700 Research Way Lakeland FL 33805-8531 Ph: (863) 603-6504 |
| NPI Number | 1619381803 |
|---|---|
| Provider Enumeration Date | 06/16/2014 |
| Last Update Date | 07/20/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619381803 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (Florida) | Primary |
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