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1851837272
RUSLAN KHAMITOV
LAKELAND, FL
NPI
1851837272
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
246ZC0007X Specialist/Technologist, Other, Surgical Assistant
(Licence: CO 15-284)
Enumeration Date
2017-01-09
Last Update Date
2017-01-09
Business Address
-- RUSLAN KHAMITOV
4619 CRESTVIEW LN
LAKELAND, FL 33813-2415
Phone number: 863-944-6935
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Mailing Address
-- RUSLAN KHAMITOV
4619 CRESTVIEW LANE
LAKELAND, FL 33813-2415
Phone number: 863-944-6935
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