Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Multi-Specialty & Primary Care Practice Group of Lake Wales LLC

Organization Specialist · NPI 1467605634

Multi-Specialty & Primary Care Practice Group of Lake Wales LLC is a Specialist in Lake Wales, Florida. Registered with an NPI since 2008.

In the registry since
2008
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

1255 State Road 60 E
Lake Wales, FL 33853
Phone: (863) 232-5111
Fax: (866) 922-0875
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X

Record details

NPI number1467605634
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kollagunta Chandrasekhar — Owner · (863) 294-5505
NPI enumeratedOctober 31, 2008
Last updated in NPPESApril 8, 2009
Mailing address1255 State Road 60 East, Lake Wales, FL 33853

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