Organization
THE LAKES ON 41 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA GHOBRIAL (OWNER)
(714) 234-6610
Entity
Organization
Contact information
Practice address
103 FLAGSHIP DR, LUTZ, FL 33549-5409
(410) 292-6965
Mailing address
103 FLAGSHIP DR, LUTZ, FL 33549-5409
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
10/17/2024
Last updated
11/12/2024
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