Active NPI 1114955598 Individual Practitioner Male Practitioner

Dr. Thomas C. Lackey , DO

Surgery • Sebring, FL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Thomas Lackey, DO is a certified Surgery practicing in Sebring, FL. With approximately 25 years of clinical experience since graduating from West Virginia School Of Osteopathic Medicine in 2001, Dr. Lackey delivers high-quality medical care to the local community at 4759 LAKEVIEW DR.

Dr. Lackey accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers, injection of chemical agent into single incompetent vein of leg using ultrasound guidance. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

4759 Lakeview Dr
Ste 101

Sebring, FL 338702005

Telephone 8634025600

Fax 8634025602

Associated Practice Facility / Clinic

🏢 Florida Lakes Anesthesia Llc Facility NPI 1023731239

Medicare Profile & Education

Medical School

West Virginia School Of Osteopathic Medicine

Graduation Year

2001

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Sebring, FL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

25 Yrs -2.3 yrs vs City Avg

City Avg: 27.3 Yrs

State Avg: 26.3 Yrs

Regional Practice Density

13 Specialists

Practicing in Sebring, FL (2030 Statewide)

Telehealth Adoption Rate

7.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

59.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Lackey (25 Years) 25 Yrs

Sebring Specialty Average (27.3 Years) 27.3 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	2,266	436	$204.00	$124.21
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	1,595	253	$258.00	$111.08
36465 Injection of chemical agent into single incompetent vein of leg using ultrasound guidance	989	210	$2400.00	$1056.34
36482 Chemical destruction of incompetent vein of arm or leg, accessed through the skin using imaging guidance	689	197	$3600.00	$1527.20
93970 Ultrasound study of arm or leg veins with compression and maneuvers	435	366	$360.00	$167.38
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	264	264	$300.00	$162.98
36466 Injection of chemical agent into multiple incompetent veins of same leg using ultrasound guidance	183	96	$3000.00	$1186.89
99213 Established patient office or other outpatient visit, typically 15 minutes	110	65	$157.75	$88.32
93925 Ultrasound of leg arteries or artery grafts	92	92	$360.00	$223.17
36483 Chemical destruction of incompetent vein of arm or leg, accessed through the skin using imaging guidance	71	46	$1200.00	$135.76
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	30	12	$151.00	$76.53
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	24	24	$224.00	$127.67

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,196	337	$175.52	$125.07
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	643	137	$223.09	$114.16
36465 Injection of chemical agent into single incompetent vein of leg using ultrasound guidance	486	116	$2063.37	$1096.51
93970 Ultrasound study of arm or leg veins with compression and maneuvers	273	233	$309.89	$170.55
36482 Chemical destruction of incompetent vein of arm or leg, accessed through the skin using imaging guidance	211	97	$3082.46	$1597.37
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	181	181	$258.01	$164.17
36466 Injection of chemical agent into multiple incompetent veins of same leg using ultrasound guidance	94	52	$2569.15	$1214.23
93925 Ultrasound of leg arteries or artery grafts	76	76	$312.63	$229.20
36471 Injection of chemical agent into multiple incompetent veins of leg	43	17	$328.02	$195.58
36483 Chemical destruction of incompetent vein of arm or leg, accessed through the skin using imaging guidance	43	30	$1009.30	$118.80
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	40	35	$194.40	$129.67
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	36	20	$130.86	$78.57
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	29	24	$322.00	$172.32
47562 Removal of gallbladder using an endoscope	26	26	$1108.46	$666.53
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	22	22	$154.09	$18.06
36571 Insertion of central venous catheter for infusion with port beneath the skin, patient 5 years or older	20	20	$1632.00	$309.43
99213 Established patient office or other outpatient visit, typically 15 minutes	19	18	$135.47	$88.30
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	15	15	$733.33	$183.30
49650 Repair of groin hernia using an endoscope	11	11	$1390.91	$406.17

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	945	292	$170.00	$126.80
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	495	144	$215.00	$117.42
36465 Injection of chemical agent into single incompetent vein of leg using ultrasound guidance	375	121	$2000.00	$1056.53
93970 Ultrasound study of arm or leg veins with compression and maneuvers	203	177	$300.00	$178.86
36482 Chemical destruction of incompetent vein of arm or leg, accessed through the skin using imaging guidance	181	94	$3000.00	$1685.28
36466 Injection of chemical agent into multiple incompetent veins of same leg using ultrasound guidance	154	84	$2500.00	$1320.96
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	122	50	$187.00	$102.39
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	103	103	$250.00	$167.35
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	102	77	$197.00	$179.96
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	88	80	$322.00	$198.00
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	69	69	$350.00	$221.84
99213 Established patient office or other outpatient visit, typically 15 minutes	46	35	$130.00	$90.19
36471 Injection of chemical agent into multiple incompetent veins of leg	41	14	$325.00	$200.75
93925 Ultrasound of leg arteries or artery grafts	41	41	$300.00	$237.94
36483 Chemical destruction of incompetent vein of arm or leg, accessed through the skin using imaging guidance	38	28	$578.95	$123.44
49653 Repair of trapped hernia using an endoscope	15	13	$1100.00	$950.51
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	12	11	$142.33	$18.82

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	673	214	$148.68	$129.34
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	413	124	$237.18	$120.04
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	314	153	$198.10	$180.12
93970 Ultrasound study of arm or leg veins with compression and maneuvers	200	164	$329.09	$182.75
36465 Injection of chemical agent into single incompetent vein of leg using ultrasound guidance	198	88	$1812.36	$1202.79
36466 Injection of chemical agent into multiple incompetent veins of same leg using ultrasound guidance	170	65	$2059.53	$1562.38
36482 Chemical destruction of incompetent vein of arm or leg, accessed through the skin using imaging guidance	139	73	$2419.49	$1833.79
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	92	92	$270.84	$223.49
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	74	74	$199.22	$167.13
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	73	65	$344.44	$201.13
99213 Established patient office or other outpatient visit, typically 15 minutes	73	47	$111.16	$90.41
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	69	34	$201.12	$103.66
36471 Injection of chemical agent into multiple incompetent veins of leg	59	18	$330.93	$201.83
93925 Ultrasound of leg arteries or artery grafts	52	50	$326.44	$247.36
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	12	11	$94.21	$52.42

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	1,243	346	$200.00	$140.45
76970 Ultrasound follow-up study	430	136	$122.75	$83.17
36482 Chemical destruction of incompetent vein of arm or leg, accessed through the skin using imaging guidance	379	124	$2283.60	$1766.23
93970 Ultrasound study of arm or leg veins with compression and maneuvers	318	262	$437.50	$180.82
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	284	42	$192.62	$129.91
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	245	245	$328.13	$202.16
36471 Injection of chemical agent into multiple incompetent veins of leg	139	52	$350.00	$189.93
93925 Ultrasound of leg arteries or artery grafts	128	128	$437.50	$237.46
36483 Chemical destruction of incompetent vein of arm or leg, accessed through the skin using imaging guidance	104	54	$161.70	$153.72
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	66	49	$312.50	$113.11
99213 Established patient office or other outpatient visit, typically 15 minutes	38	26	$105.00	$71.96
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	36	24	$273.13	$101.64
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	36	34	$470.94	$198.05
36465 Injection of chemical agent into single incompetent vein of leg using ultrasound guidance	35	26	$1786.73	$1254.67
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	33	27	$292.49	$54.73
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	26	23	$112.50	$51.13
36466 Injection of chemical agent into multiple incompetent veins of same leg using ultrasound guidance	25	17	$1866.72	$1544.10
99306 Initial nursing facility visit, typically 45 minutes per day	23	23	$241.77	$162.27
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	19	18	$143.00	$104.37
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	17	12	$129.44	$88.53

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	1,272	352	$200.00	$143.24
76970 Ultrasound follow-up study	421	130	$122.75	$86.70
36482 Chemical destruction of incompetent vein of arm or leg, accessed through the skin using imaging guidance	401	131	$2283.60	$1972.37
93970 Ultrasound study of arm or leg veins with compression and maneuvers	252	217	$437.50	$187.74
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	203	203	$328.13	$205.45
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	108	24	$129.44	$91.35
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	101	28	$192.62	$135.28
36471 Injection of chemical agent into multiple incompetent veins of leg	88	41	$350.00	$181.34
93925 Ultrasound of leg arteries or artery grafts	79	79	$437.50	$247.66
36483 Chemical destruction of incompetent vein of arm or leg, accessed through the skin using imaging guidance	71	43	$161.70	$151.84
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	66	53	$312.50	$115.66
99213 Established patient office or other outpatient visit, typically 15 minutes	40	31	$105.00	$73.23
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	36	16	$273.13	$104.38
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	36	20	$292.49	$56.07
99306 Initial nursing facility visit, typically 45 minutes per day	28	28	$241.77	$166.62
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	26	25	$470.94	$197.11
91037 Monitoring and recording of esophageal function through nasal tube with electrode	22	21	$174.78	$159.98
91010 Study of esophagus to assess movement	22	21	$192.24	$185.10
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	21	17	$143.00	$107.47
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	19	19	$522.99	$145.41
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	13	12	$190.65	$130.25
43281 Repair of hernia of muscle at esophagus and stomach using an endoscope	12	12	$1889.17	$1634.89
91034 Monitoring and recording of gastroesophageal reflux through nose including analysis and interpretation	11	11	$203.86	$184.84

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	1,418	402	$200.00	$135.71
76970 Ultrasound follow-up study	449	150	$122.75	$84.30
36482 Chemical destruction of incompetent vein of arm or leg, accessed through the skin using imaging guidance	354	133	$2283.60	$1925.12
93970 Ultrasound study of arm or leg veins with compression and maneuvers	290	236	$437.50	$180.61
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	281	38	$129.44	$86.39
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	238	238	$328.13	$195.53
36471 Injection of chemical agent into multiple incompetent veins of leg	134	49	$350.00	$175.63
93925 Ultrasound of leg arteries or artery grafts	108	108	$437.50	$239.80
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	104	42	$273.13	$98.91
99213 Established patient office or other outpatient visit, typically 15 minutes	76	39	$105.00	$68.09
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	65	55	$470.94	$192.84
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	57	38	$292.49	$55.68
36475 Destruction of insufficient vein of arm or leg, accessed through the skin	37	19	$2058.49	$1392.53
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	33	16	$192.62	$128.39
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	27	16	$312.50	$107.82
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	26	17	$143.00	$100.81
47562 Removal of gallbladder using an endoscope	26	26	$1168.61	$650.56
36483 Chemical destruction of incompetent vein of arm or leg, accessed through the skin using imaging guidance	20	16	$161.70	$137.17
36478 Laser destruction of incompetent vein of arm or leg using imaging guidance	17	16	$1865.00	$1114.87
91010 Study of esophagus to assess movement	17	17	$192.24	$163.23
99306 Initial nursing facility visit, typically 45 minutes per day	17	17	$241.77	$157.60
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	17	17	$190.65	$123.71
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	17	15	$150.00	$17.87
91034 Monitoring and recording of gastroesophageal reflux through nose including analysis and interpretation	14	14	$203.86	$172.78
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	14	14	$522.99	$104.37
91037 Monitoring and recording of esophageal function through nasal tube with electrode	13	13	$174.78	$148.33
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	12	12	$619.92	$183.48
11042 Removal of skin and tissue, 20.0 sq cm or less	12	11	$127.88	$47.50
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	11	11	$373.97	$122.62

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	1,016	349	$200.13	$133.55
76970 Ultrasound follow-up study	469	146	$122.75	$74.78
36478 Laser destruction of incompetent vein of arm or leg using imaging guidance	341	123	$1865.00	$1093.70
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	307	186	$143.74	$99.28
93970 Ultrasound study of arm or leg veins with compression and maneuvers	271	234	$437.50	$176.98
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	235	235	$328.13	$193.05
36471 Injection of chemical agent into multiple incompetent veins of leg	231	87	$350.00	$152.94
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	200	37	$129.76	$84.99
99213 Established patient office or other outpatient visit, typically 15 minutes	122	76	$106.56	$67.51
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	122	40	$273.13	$97.84
93925 Ultrasound of leg arteries or artery grafts	111	110	$437.50	$233.80
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	107	58	$292.49	$55.48
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	74	60	$470.94	$190.42
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	55	25	$192.62	$126.71
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	41	41	$232.09	$152.99
36479 Laser destruction of incompetent veins of arm or leg using imaging guidance, subsequent	41	32	$570.00	$288.63
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	30	30	$190.65	$121.52
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	24	19	$312.50	$108.53
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	23	16	$183.44	$67.59
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	19	12	$93.75	$38.04
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	17	16	$522.99	$126.36
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	15	15	$112.50	$49.60
47562 Removal of gallbladder using an endoscope	15	15	$1168.61	$647.18
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$184.90	$100.37
99306 Initial nursing facility visit, typically 45 minutes per day	12	12	$241.77	$155.86

Medical Specialties & State Licenses

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License FL OS10031

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

279537000 (FL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners

Melina Hoffman , NP

Nurse Practitioner

NPI 1083066070

Nurse Practitioner

Dr. Gregg Shore , MD

Colon & Rectal Surgery

NPI 1235138983

Doctor of Medicine (M.D.)

Mayelin Fernandez Fuentes , APRN

Family Medicine - Geriatric Medicine

NPI 1457021081

Advanced Practice Registered Nurse

Rachel Sims , APRN

Nurse Practitioner

NPI 1629592134

Advanced Practice Registered Nurse

Michael Hernicz , CRNA

Nurse Anesthetist, Certified Registered

NPI 1790730943

Certified Registered Nurse Anesthetist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events

✅

NPI Profile Active April 09, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location April 09, 2017

Registered at 4759 LAKEVIEW DR, STE 101, SEBRING, FL 338702005 (Tel: 8634025600)

📍

Updated Business Mailing Address April 09, 2017

Registered at 4759 LAKEVIEW DR, STE 101, SEBRING, FL 338702005 (Tel: 8634025600)

👤

Provider Name / Credentials Updated April 09, 2017

Recorded as THOMAS LACKEY, D. O.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 09, 2017

Surgery (License #OS10031 in FL)

✅

NPI Profile Active January 20, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location January 20, 2016

Registered at 4759 LAKEVIEW DR, STE 101, SEBRING, FL 338702005 (Tel: 8634025600)

📍

Updated Business Mailing Address January 20, 2016

Registered at 4759 LAKEVIEW DR, STE 101, SEBRING, FL 338702005 (Tel: 8634025600)

👤

Provider Name / Credentials Updated January 20, 2016

Recorded as THOMAS LACKEY, D. O.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 20, 2016

Surgery (License #OS10031 in FL)

🟢

Initial NPI Registration & Enumeration June 28, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114955598

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 28, 2006

Last Update: April 09, 2017

Sole Proprietor: No

Update or Correct Profile

Mailing Address

4759 Lakeview Dr, Ste 101

Sebring, FL 338702005

Phone: 8634025600

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.