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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