Organization · Type 2 NPI
Health Medical Ultra Limited Liability Company
Adult Medicine Physician · Polk City, FL
NPI number
1528992872
Active
Practice location
116 Commonwealth Ave SW
Polk City, FL 33868
Fax (863) 875-4681
Mailing address
2402 Lake Dr NW
Winter Haven, FL 33881-5008
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Medicine Physician Primary | 207QA0505X | None listed |
| General Practice Physician | 208D00000X | None listed |
| Family Nurse Practitioner | 363LF0000X | None listed |
Adult Medicine Physician: The NUCC recommends this code not be used. Choose a more appropriate code.
About NPI 1528992872
Health Medical Ultra Limited Liability Company's National Provider Identifier is 1528992872, issued on Jun 11, 2026. The primary taxonomy on file is Adult Medicine Physician (207QA0505X), and the practice location is in Polk City, FL. The record was last updated on Jun 11, 2026.