Lake Miriam Campus - Primary Care in Lakeland, FL

Lake Miriam Campus is a primary clinic (Clinic/center - Multi-specialty) in Lakeland, Florida. The current practice location for Lake Miriam Campus is 4710 S Florida Ave, Lakeland, Florida. For appointments, you can reach them via phone at (863) 284-6800. The mailing address for Lake Miriam Campus is 1324 Lakeland Hills Blvd, Managed Care Dept, Lakeland, Florida and phone number is (863) 687-1100.

Lake Miriam Campus is licensed to practice in Florida (license number ) and its NPI number is 1063858538. This medical practice does not participate in medicare program and thus may not accept your medicare insurance. You may check if they accept your insurance at (863) 284-6800.

Contact Information

Lake Miriam Campus
4710 S Florida Ave
Lakeland
FL 33813-2165
(863) 284-6800
(863) 284-6807

Primary Care Clinic Profile

Full NameLake Miriam Campus
SpecialityClinic/center - Multi-specialty
Location4710 S Florida Ave, Lakeland, Florida
Authorized Official Name and PositionLance Green (VP/CFO)
Authorized Official Contact8636871100
Accepts Medicare InsuranceThis clinic does not participate in Medicare Program.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Lake Miriam Campus
1324 Lakeland Hills Blvd
Managed Care Dept
Lakeland
FL 33805

Ph: (863) 687-1100
Lake Miriam Campus
4710 S Florida Ave
Lakeland
FL 33813-2165

Ph: (863) 284-6800

NPI Details:

NPI Number1063858538
Provider Enumeration Date05/10/2013
Last Update Date01/24/2023

Medical Identifiers

Medical identifiers for Lake Miriam Campus such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063858538NPI-NPPES
263421005MedicaidFL

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Secondary
207R00000XInternal Medicine (* (Not Available))Secondary
207RG0300XInternal Medicine - Geriatric Medicine (* (Not Available))Secondary
208D00000XGeneral Practice (* (Not Available))Secondary
261QM1300XClinic/center - Multi-specialty (Florida)Primary
363LF0000XNurse Practitioner - Family (* (Not Available))Secondary

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