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Organization
SANDLAKE FAMILY CARE PA
Active
Organization
SANDLAKE FAMILY CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GHYEATH AYOUBI M.D. (PRESIDENT)
(407) 352-8188
Entity
Organization
Contact information
Practice address
7364 STONEROCK CIR, STE B, ORLANDO, FL 32819-8000
(407) 352-8188
(407) 351-9057
Mailing address
PO BOX 690871, ORLANDO, FL 32869-0871
(407) 352-8188
(407) 351-9057
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
377305101
—
FL
01
—
K4707
CORPORATION
FL
Enumeration date
10/15/2007
Last updated
08/06/2010
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