| Organization Name: | JOGI WALK-IN CLINIC INC |
| NPI Number: | 1629027008 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUGUNA KUMARI MANGILIPUDI (OWNER) |
| Mailing Address: | 1500 Lakeland Hills Blvd Suite #3 Lakeland |
| State: | FL US |
| Postal Code: | 338053257 |
| Phone Number: | 8636828200 |
| Fax Number: | 8636874161 |
| NPI Enumeration Date: | 05/10/2006 |
| NPI Last Update Date: | 01/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |