Provider Demographics
NPI:1164229639
Name:LUMOS LACTATION
Entity type:Organization
Organization Name:LUMOS LACTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DASH
Authorized Official - Suffix:
Authorized Official - Credentials:DC, IBCLC
Authorized Official - Phone:561-373-2407
Mailing Address - Street 1:148 MAJESTIC FOREST RUN
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-7172
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:148 MAJESTIC FOREST RUN
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-7172
Practice Address - Country:US
Practice Address - Phone:561-290-2645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service