Individual
LUBOMYR LAZOR MUTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C, IMG.
Contact information
Practice address
5963 CHURCHILL SQUARE WAY, GROVELAND, FL 34736-3128
(407) 927-0778
Mailing address
5963 CHURCHILL SQUARE WAY, GROVELAND, FL 34736-3128
(407) 927-0778
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
19543
WI
Other
Enumeration date
04/27/2020
Last updated
04/27/2020
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