Healthcare Provider Details

I. General information

NPI: 1538362272
Provider Name (Legal Business Name): JANELLE PEERY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANELLE SPAULDING M. D.

II. Dates (important events)

Enumeration Date: 06/08/2007
Last Update Date: 02/24/2023
Certification Date: 02/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 HARDEN BLVD
LAKELAND FL
33803-7952
US

IV. Provider business mailing address

1324 LAKELAND HILLS BLVD ATTN: MANAGED CARE DEPT.
LAKELAND FL
33805-4543
US

V. Phone/Fax

Practice location:
  • Phone: 863-284-6800
  • Fax: 863-284-6825
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2009005458
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME130622
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: