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NPI Code Detail

MEDICARE: LAKELAND INVESTORS LLC

MEDICARE: LAKELAND INVESTORS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing FacilityFL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720089394
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKELAND INVESTORS LLC
Provider Business Mailing Address
First Line : 2123 CENTRE POINTE BLVD
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32308-4930
Country : US
Telephone Number : 850-386-2831
Fax Number : 850-386-2016
Provider Business Practice Location Address
First Line : 1350 SLEEPY HILL RD
Second Line :
City : LAKELAND
State : FL
Zip : 33810-3800
Country : US
Telephone Number : 863-858-4402
Fax Number : 863-858-6759
Authorized Official
Title or Position : PRESIDENT
Name : MR. JOSEPH D. MITCHELL
Credential :
Telephone Number : 850-386-2831
Provider Enumeration Date : 08/04/2005
Last Update Date : 01/11/2022

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Directions to “LAKELAND INVESTORS LLC ” Practice Location

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