Lakewood Ccl, LLC

NPI #1922575802 in Wildwood, Florida

Provider Information

NPI Number
1922575802
Entity Type
Organization
Organization Name
Lakewood Ccl, LLC
Primary Specialty
Clinic/Center - Multi-Specialty
Enumeration Date
Oct 29, 2018
Last Updated
Oct 29, 2018

Practice Location

Address
5571 E SR 44 STE 501
State
Florida
ZIP Code
34785-8282
Phone
(352) 643-9070

Authorized Official

Name
MR. JOSE A RIVERA
Title
ADMINISTRATOR
Phone
(352) 643-9070

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Multi-SpecialtyMulti-Specialty

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