Most Relevant Information
Provider Data
| NPI Number: | 1003382185 |
| Provider Name: | MICHELLE DAVID |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/16/2018 |
| Last Updated: | 02/20/2020 |
Provider Practice Location
621 N LAKE PARKER AVE
LAKELAND
FL
338012040
Practice Location Phone/Fax
| Phone: | 8635190575 |
| Fax: |
Provider Mailing Location
PO BOX 1559
BARTOW
FL
338311559
Provider Mailing Phone/Fax
| Phone: | 8635190575 |
| Fax: |