LAKE BUTLER MEDICAL CLINIC INC
Ambulatory Health at Main St, Lulu, FL

License number
Florida ME81421
Category
Ambulatory Health
Type
Clinic/Center
Owner
Name: MARTHA REGINA LLOYD MD
Title: PHYSICIAN
Phone: (386) 496-1328
Address
Address
675 E Main St, Lulu, FL 32054
National Provider ID: 1871582296
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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LAKE BUTLER MEDICAL CLINIC, INC

Lulu, FL

Industry:
Medical Doctor's Office
Registration:
Jun 16, 2003
Phone:
(386) 496-1328 (Phone)
Addresses:
675 E Main St, Lake Butler, FL 32054 (Physical)
Lake Butler, FL 32054 (Mailing)
PO Box 188, Lulu, FL 32054
State ID:
P03000068048
Business type:
Florida Profit Corporation
President, Treasurer, Secretary, Director, Vice President:
Martha Lloyd (President, Treasurer, Secretary, Director, Vice President), 605 NE 1 St, Lake Butler, FL 32054 (Physical)
Agent:
Lloyd, Martha,605 NE 1 St, Lake Butler, FL 32054 (Physical)
EIN:
542118362

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