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General NPI Number Information
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NPI Number | 1497688980
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Entity Type | Organization
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Legal Business Name | ST. LUKE PHYSICIAN PARTNERS PLLC
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Dates
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Enumeration Date | 06/04/2026
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Last Update Date | 06/04/2026
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Provider Practice Location Address
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Address Line | 199 AVE B NORTH WEST STE 310
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City | WINTER HAVEN
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State | FL
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Zip | 33881
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Country | US
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Telephone | 863-284-5000
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Fax | 863-284-1875
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Provider Business Mailing Address
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Address Line | 3616 HARDEN BLVD
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City | LAKELAND
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State | FL
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Zip | 33803-5938
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Country | US
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Telephone | 863-399-3365
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Fax |
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Authorized Official
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Title or Position | MGR
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Name | MARIA DEL MAR FELIX MORALES,
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Credential | MD
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Telephone | 863-399-3365
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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