Provider Demographics
NPI:1093939290
Name:LAKELAND VOLUNTEERS IN MEDICINE
Entity Type:Organization
Organization Name:LAKELAND VOLUNTEERS IN MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:N
Authorized Official - Last Name:BARRIOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-688-5846
Mailing Address - Street 1:1021 LAKELAND HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-4672
Mailing Address - Country:US
Mailing Address - Phone:863-688-5846
Mailing Address - Fax:863-802-4640
Practice Address - Street 1:1021 LAKELAND HILLS BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-4672
Practice Address - Country:US
Practice Address - Phone:863-688-5846
Practice Address - Fax:863-802-4640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable