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General NPI Number Information
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NPI Number | 1245486869
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Entity Type | Individual
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Provider Name | KING FERNAND LMT
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Gender | Male
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Dates
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Enumeration Date | 08/14/2008
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Last Update Date | 01/25/2026
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Provider Practice Location Address
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Address Line | 2240 US HIGHWAY 92 E
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City | LAKELAND
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State | FL
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Zip | 33801-2448
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Country | US
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Telephone | 863-286-1962
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 496
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City | LAKELAND
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State | FL
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Zip | 33802-0496
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Country | US
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Telephone | 863-286-1962
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA47453
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License Number State | FL
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