Individual
DR. RICHARD B LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
6027 CYPRESS GARDENS BLVD, WINTER HAVEN, FL 33884-4115
(863) 326-5824
Mailing address
685 SHANKLIN AVE, BARTOW, FL 33830-4335
(863) 533-1363
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OP1036
FL
Other
Enumeration date
07/01/2005
Last updated
08/21/2007
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