Organization · NPI-2

Cannacare Medical Group LLC

Clinic/Center · Lakeland, FL

NPI number1780345728
StatusActive
Last updated in NPPESJan 3, 2022

Details

NPI
1780345728
Entity type
Organization (NPI-2)
Legal business name
Cannacare Medical Group LLC
Organization subpart
No
Enumeration date
Jan 3, 2022
Certification date
Jan 3, 2022
Last updated
Jan 3, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Practice location

1046 S Florida Ave
Lakeland, FL 33803-1118

Phone 800-201-3624

Mailing address

2137 Sandy Hook
Lakeland, FL 33813-1350

Phone 918-914-0895

Authorized official

Jocelyn Grace Edmundson
Office Manager
9189140895

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Clinic/Center providers in Lakeland, FL