Healthcare Provider Details

I. General information

NPI: 1326708629
Provider Name (Legal Business Name): MR. SANDU LAMA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2021
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2761 CITRUS TOWER BLVD STE 103
CLERMONT FL
34711-7010
US

IV. Provider business mailing address

16343 CAGAN CROSSINGS BLVD APT 301
CLERMONT FL
34714-8923
US

V. Phone/Fax

Practice location:
  • Phone: 352-227-1757
  • Fax:
Mailing address:
  • Phone: 262-226-0636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT22729
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: