BRIAN MATTHEW LAKE

LARGO, FL
NPI1295887040
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism
(Licence: FL  OS9591)
Additional Taxonomies207R00000X Internal Medicine
(Licence: FL  OS9591)
207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism
(Licence: SC  1056)
Enumeration Date2007-01-18
Last Update Date2021-05-02
Business Address
DR. BRIAN MATTHEW LAKE D.O.
13123 66TH ST
LARGO, FL 33773-1812
Phone number: 727-477-1039
Mailing Address
DR. BRIAN MATTHEW LAKE D.O.
13123 66TH ST
LARGO, FL 33773-1812
Phone number: 727-477-1039