Individual
LAKETRIA POPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
300 WILSHIRE BLVD STE 221, CASSELBERRY, FL 32707-5369
(407) 900-0519
Mailing address
300 WILSHIRE BLVD STE 221, CASSELBERRY, FL 32707-5369
(407) 900-0519
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
5235545
FL
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101367700
—
FL
Enumeration date
02/12/2019
Last updated
02/27/2019
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