Provider Demographics
NPI:1326708629
Name:LAMA, SANDU
Entity Type:Individual
Prefix:MR
First Name:SANDU
Middle Name:
Last Name:LAMA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9418 N GREEN BAY RD APT 366
Mailing Address - Street 2:
Mailing Address - City:BROWN DEER
Mailing Address - State:WI
Mailing Address - Zip Code:53209-1073
Mailing Address - Country:US
Mailing Address - Phone:262-226-0636
Mailing Address - Fax:
Practice Address - Street 1:2761 CITRUS TOWER BLVD STE 103
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-7010
Practice Address - Country:US
Practice Address - Phone:352-227-1757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-28
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist