Healthcare Provider Details
I. General information
NPI: 1093675787
Provider Name (Legal Business Name): LAKEN PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/14/2025
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11109 W COLONIAL DR
OCOEE FL
34761-2935
US
IV. Provider business mailing address
3470 17TH ST
SARASOTA FL
34235-8906
US
V. Phone/Fax
- Phone: 407-554-2110
- Fax: 407-554-2111
- Phone: 941-544-6727
- Fax: 941-955-0800
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ELDER
EUCLIDES
SORIA-FERRAS
Title or Position: OWNER/PHARMACIST
Credential: RPH
Phone: 941-544-6727