Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lake Wales Clinic Corp

Organization Family Medicine Physician · NPI 1457350027

Lake Wales Clinic Corp is a Family Medicine Physician in Lake Wales, Florida. Registered with an NPI since 2005.

In the registry since
2005
Specialties on file
8
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

410 S 11th St
Lake Wales, FL 33853-4203
Phone: (863) 676-1433
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Gastroenterology Physician Taxonomy 207RG0100X
Orthopaedic Surgery Physician Taxonomy 207X00000X
Pediatrics Physician Taxonomy 208000000X
Clinical Neurophysiology Physician Taxonomy 2084N0600X
Sleep Medicine (Psychiatry & Neurology) Physician Taxonomy 2084S0012X
Surgery Physician Taxonomy 208600000X

Record details

NPI number1457350027
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationLake Wales Clinic Corp
Authorized official James Wright — Vp Physician Business Services · (615) 778-1502
NPI enumeratedJuly 18, 2005
Last updated in NPPESJuly 22, 2019
Mailing addressPo Box 689022, Franklin, TN 37068-9022

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