Lidzoe Correa- Mateo, M.D.
General Practice in Lakeland, FL. Individual provider (NPI-1).
NPI number1609040229
StatusActive
Last updated in NPPESMay 7, 2024
Details
- NPI
- 1609040229
- Entity type
- Individual (NPI-1)
- Name
- Lidzoe Correa- Mateo
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 15, 2008
- Certification date
- May 7, 2024
- Last updated
- May 7, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | ACN895 | FL | Yes |
| 208D00000X | General Practice | 17095 | PR |
Practice location
5985 S Florida AveLakeland, FL 33813-2533
Phone 863-644-8459
Mailing address
5985 S Florida AveLakeland, FL 33813-2533
Phone 863-644-8459
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