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General NPI Number Information
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NPI Number | 1205962131
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Entity Type | Organization
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Legal Business Name | PHYSICIANS SERVICES LLC
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 02/22/2012
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Provider Practice Location Address
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Address Line | 1143 STATE ROAD 60 E
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City | LAKE WALES
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State | FL
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Zip | 33853-4320
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Country | US
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Telephone | 863-679-8815
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Fax | 863-679-8335
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Provider Business Mailing Address
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Address Line | 1143 STATE ROAD 60 E
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City | LAKE WALES
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State | FL
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Zip | 33853-4320
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Country | US
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Telephone | 863-679-8815
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Fax | 863-679-8335
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KULMEET SINGH KUNDLAS
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Credential | M.D.
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Telephone | 863-679-8815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME73743
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License Number State | FL
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