NPIMap

Organization Active NPI

Physicians Services LLC

  • Internal Medicine Physician
  • Lake Wales, FL
National Provider Identifier
1205962131
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME73743 Issued in FL
Legal business name
PHYSICIANS SERVICES LLC
Practice address
1143 State Road 60 E
Lake Wales, FL 33853-4320
Phone
(863) 679-8815
Fax
(863) 679-8335
NPI assigned
Feb 26, 2007
Last updated
Feb 22, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kulmeet Singh Kundlas, M.D.NPI 1336293497
Title
President
Phone
(863) 679-8815

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME73743 FL Primary

Addresses

Primary practice location

1143 State Road 60 E
Lake Wales, FL 33853-4320

Mailing address

1143 State Road 60 E
Lake Wales, FL 33853-4320
Phone (863) 679-8815

Other identifiers 2

IdentifierTypeStateIssuer
257758500MedicaidFL
ME73743OtherFLMEDICAL LICENSE

National Provider Directory

National Provider Directory

Locations

1400 Chalet Suzanne Rd
Lake Wales, FL 33859
Phone (863) 678-1975

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329868800000",
    "number": "1205962131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1143 STATE ROAD 60 E",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534320",
            "telephone_number": "863-679-8815",
            "fax_number": "863-679-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1143 STATE ROAD 60 E",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534320",
            "telephone_number": "863-679-8815",
            "fax_number": "863-679-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2012-02-22",
        "status": "A",
        "authorized_official_last_name": "KUNDLAS",
        "authorized_official_first_name": "KULMEET",
        "authorized_official_middle_name": "SINGH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-679-8815",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME73743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257758500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME73743",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.