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

Dr. Manoj Kumar Dhariwal, MD

Individual provider Family Medicine Physician · NPI 1457544629

Dr. Manoj Kumar Dhariwal, MD is a Sports Medicine in Lakeland, Florida. Qualified in 2006, 20 years ago. Practices with Legacy Healthcare Services Inc, a 3,624-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
20
Licensed in
FL
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2300 E County Road 540A
Lakeland, FL 33813-3825
Phone: (863) 680-7000
Fax: (866) 264-8519
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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 · Licence ME110624 (FL)

Record details

NPI number1457544629
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 21, 2007
Last updated in NPPESJuly 27, 2022
Certification dateJuly 27, 2022
Mailing address1600 Lakeland Hills Blvd, Lakeland, FL 33805-3065

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtySPORTS MEDICINE
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Legacy Healthcare Services Inc — 3624 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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