Healthcare Provider Details

I. General information

NPI: 1467838235
Provider Name (Legal Business Name): UVONDA LASSITER LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2015
Last Update Date: 08/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 E SILVER SPRINGS BLVD
OCALA FL
34470-6831
US

IV. Provider business mailing address

141 PINE TRCE
OCALA FL
34472-5621
US

V. Phone/Fax

Practice location:
  • Phone: 352-369-3320
  • Fax:
Mailing address:
  • Phone: 318-623-7324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN5198385
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: