Lettuce Lake Emergency Physicians LLC

NPI #1699293225 in Lutz, Florida

Provider Information

NPI Number: 1699293225
Entity Type: Organization
Organization Name: Lettuce Lake Emergency Physicians LLC
Primary Specialty: Emergency Medicine
Enumeration Date: Sep 4, 2017
Last Updated: Dec 22, 2020

Practice Location

Address: 1430 DALE MABRY HIGHWAY
City: Lutz
State: Florida
ZIP Code: 33548
Phone: (469) 401-2386

Authorized Official

Name: KATHY KONDAS
Title: OFFICER
Phone: (973) 251-1132

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X
Nurse Practitioner	363L00000X
Emergency Medicine	207P00000X	Primary

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