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

Mis Provider Network LLC

Organization Counselor · NPI 1700529369

Mis Provider Network LLC is a Counselor in Lakeland, Florida. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

170 Fitzgerald Rd Ste 1
Lakeland, FL 33813-2633
Phone: (813) 687-5858
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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
Counselor Taxonomy 101Y00000X
Mental Health Counselor Taxonomy 101YM0800X

Record details

NPI number1700529369
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Wendy Bradshaw — Owner · (813) 687-5858
NPI enumeratedApril 20, 2022
Last updated in NPPESApril 20, 2022
Certification dateApril 20, 2022
Mailing address170 Fitzgerald Rd Ste 1, Lakeland, FL 33813-2633

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