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General NPI Number Information
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NPI Number | 1639496540
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Entity Type | Organization
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Legal Business Name | LWR FAMILY PRACTICE WALK-IN PL
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Dates
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Enumeration Date | 05/02/2010
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Last Update Date | 01/22/2026
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Provider Practice Location Address
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Address Line | 8431 HERITAGE GREEN WAY
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34212-1400
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Country | US
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Telephone | 941-896-3900
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Fax | 941-896-3901
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Provider Business Mailing Address
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Address Line | 8431 HERITAGE GREEN WAY
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34212-1400
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Country | US
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Telephone | 941-896-3900
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Fax | 941-896-3901
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Authorized Official
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Title or Position | PA-C
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Name | MARY MOTT
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Credential |
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Telephone | 941-896-3900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | PA9101315
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License Number State | FL
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