Lakeview Specialist Group, LLC
Specialist in Summerfield, FL. Organization (NPI-2).
NPI number1043869332
StatusActive
Last updated in NPPESSep 12, 2019
Details
- NPI
- 1043869332
- Entity type
- Organization (NPI-2)
- Legal business name
- Lakeview Specialist Group, LLC
- Organization subpart
- No
- Enumeration date
- Sep 9, 2019
- Last updated
- Sep 12, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | – | Yes |
Practice location
10250 Se 167th Place Rd Unit 5Summerfield, FL 34491-8682
Phone 352-307-9925
Mailing address
10250 Se 167th Place Rd Unit 5Summerfield, FL 34491-8682
Phone 352-307-9925
Authorized official
Khai Chang
Owner
3523079925
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