Healthcare Provider Details

I. General information

NPI: 1629149067
Provider Name (Legal Business Name): ARLENE PHYLLIS BEVERLEY WALKER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3240 S FLORIDA AVE STE 101
LAKELAND FL
33803-4574
US

IV. Provider business mailing address

425 W COLONIAL DR STE 303
ORLANDO FL
32804-6863
US

V. Phone/Fax

Practice location:
  • Phone: 863-644-7337
  • Fax: 833-450-4915
Mailing address:
  • Phone: 321-632-2190
  • Fax: 689-304-0303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberPA3581
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA3581
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: