Lomba MD PA
Pathology, Anatomic Pathology & Clinical Pathology in Lake Wales, FL. Organization (NPI-2).
NPI number1336719699
StatusActive
Last updated in NPPESJun 29, 2021
Details
- NPI
- 1336719699
- Entity type
- Organization (NPI-2)
- Legal business name
- Lomba MD PA
- Organization subpart
- No
- Enumeration date
- Jun 29, 2021
- Certification date
- Jun 29, 2021
- Last updated
- Jun 29, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207ZP0102X | Pathology, Anatomic Pathology & Clinical Pathology | – | – | Yes |
Practice location
410 S 11th StLake Wales, FL 33853-4203
Phone 863-676-1433
Mailing address
Po Box 742291Atlanta, GA 30374-2291
Authorized official
Fernando Luis Lomba
Owner
9417664120
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