Individual
LEAH LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CERTIFIED NURSE ASSI
Contact information
Practice address
5401 S KIRKMAN RD STE 310, ORLANDO, FL 32819-7937
(321) 332-4455
Mailing address
5401 S KIRKMAN RD STE 310, ORLANDO, FL 32819-7937
(321) 332-4455
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
05/16/2018
Last updated
05/16/2018
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