Healthcare Provider Details

I. General information

NPI: 1841753597
Provider Name (Legal Business Name): CAITLIN A COMBS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2019
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1324 LAKELAND HILLS BLVD
LAKELAND FL
33805-4543
US

IV. Provider business mailing address

2226 GOLD DUST DR
MINNEOLA FL
34715-9322
US

V. Phone/Fax

Practice location:
  • Phone: 863-687-1132
  • Fax:
Mailing address:
  • Phone: 407-792-8909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License NumberME157199
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME157199
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: