| Lakewood Ranch Medical Group Llc | |
|
8340 Lakewood Ranch Blvd Suite 140 Lakewood Ranch FL 34202-5180 | |
| (941) 782-2800 | |
| (941) 782-2513 |
| Full Name | Lakewood Ranch Medical Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 8340 Lakewood Ranch Blvd, Lakewood Ranch, Florida |
| Authorized Official Name and Position | Cecilia D Carag (DELEGATED OFFICER) |
| Authorized Official Contact | 9417822800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakewood Ranch Medical Group Llc Po Box 281741 Atlanta GA 30384-1741 Ph: (941) 782-2800 | Lakewood Ranch Medical Group Llc 8340 Lakewood Ranch Blvd Suite 140 Lakewood Ranch FL 34202-5180 Ph: (941) 782-2800 |
| NPI Number | 1093975062 |
|---|---|
| Provider Enumeration Date | 06/13/2008 |
| Last Update Date | 05/24/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093975062 | NPI | - | NPPES |
| DN8672 | Other | FL | RAIL ROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Florida) | Primary |
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