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General NPI Number Information
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NPI Number | 1902011638
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Entity Type | Organization
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Legal Business Name | LB'S HANDICARE, INC.
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 06/23/2009
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Provider Practice Location Address
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Address Line | 7421 SW 128TH TER
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City | ARCHER
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State | FL
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Zip | 32618-2921
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Country | US
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Telephone | 352-246-3901
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Fax |
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Provider Business Mailing Address
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Address Line | 7421 SW 128TH TER
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City | ARCHER
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State | FL
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Zip | 32618-2921
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. LYNDON B MOORE
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Credential |
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Telephone | 352-246-3901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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