Organization Active NPI

Wilbur R. Reschly, M.D., P.a.

  • Dermatology Physician
  • Lakeland, FL
National Provider Identifier
1700900461
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME24895 Issued in FL
Legal business name
WILBUR R. RESCHLY, M.D., P.A.
Practice address
4316 Highland Park Blvd
Lakeland, FL 33813-1647
Phone
(863) 644-6415
Fax
(863) 709-8345
NPI assigned
Mar 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Wilbur R Reschly, M.D.
Title
President
Phone
(863) 644-6415

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X ME24895 FL Primary

Addresses

Primary practice location

4316 Highland Park Blvd
Lakeland, FL 33813-1647

Mailing address

4316 Highland Park Blvd
Lakeland, FL 33813-1647
Phone (863) 644-6415

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700900461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4316 HIGHLAND PARK BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131647",
            "telephone_number": "863-644-6415",
            "fax_number": "863-709-8345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4316 HIGHLAND PARK BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131647",
            "telephone_number": "863-644-6415",
            "fax_number": "863-709-8345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILBUR R. RESCHLY, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RESCHLY",
        "authorized_official_first_name": "WILBUR",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-644-6415",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME24895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.