| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1396734448 | HODGES | PAMELA | S | 215 IMPERIAL BLVD STE B2 | LAKELAND | FL | 338034689 | |
| 1619370053 | WIRTH | AMANDA | JENE | 215 IMPERIAL BLVD STE B2 | LAKELAND | FL | 338034689 | |
| 1760861538 | YOUNG | JILL | ALLISON | 215 IMPERIAL BLVD STE B2 | LAKELAND | FL | 338034689 |