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Organization
PRO2 LAKE CITY, LLC
Active
Organization
PRO2 LAKE CITY, LLC
Active
Other names
PRO2 Respiratory Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY FORD (PRESIDENT)
(513) 469-5771
Entity
Organization
Contact information
Practice address
4550 SW 41ST BLVD, SUITE 7, GAINESVILLE, FL 32608
(386) 755-9511
(386) 755-9577
Mailing address
4550 SW 41ST BLVD, SUITE 7, GAINESVILLE, FL 32608-4255
(386) 755-9511
(386) 755-9577
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
1312130
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031183900
—
FL
Enumeration date
07/12/2006
Last updated
07/17/2015
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