Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Polk Concierge Medical Group, LLC

Organization Nurse Practitioner · NPI 1235824640

Polk Concierge Medical Group, LLC provides Nurse Practitioner services in Lakeland, Florida. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

304 E Pine St # 1143
Lakeland, FL 33801-4969
Phone: (863) 339-2025
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X

Record details

NPI number1235824640
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Asia Standifer — Ceo · (352) 807-2197
NPI enumeratedApril 11, 2023
Last updated in NPPESApril 11, 2023
Certification dateApril 11, 2023
Mailing address304 E Pine St # 1143, Lakeland, FL 33801-4969

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