Graduated: 2015
NPI: 1013468362
Practice Locations (2)
LAKE WALES PHYSICIAN SERVICES, LLC
410 S 11TH ST
LAKE WALES, FL 338534203
8636761433
OHI WEST MEDICAL GROUP II LLC
38135 MARKET SQUARE DR, SUITE 109
ZEPHYRHILLS, FL 335427505
8137780444
Source: CMS National Downloadable File, September 2026.