Graduated: 2019
NPI: 1013577998
Practice Locations (2)
LAKE WALES PHYSICIAN SERVICES, LLC
410 S 11TH ST
LAKE WALES, FL 338534203
8636761433
WEIRSDALE FAMILY HEALTH CENTER INC
16400 S HWY 25
WEIRSDALE, FL 321952442
3528219797
Source: CMS National Downloadable File, September 2026.