Provider Demographics
NPI:1275325060
Name:LAKEWOOD RANCH RETINA PLLC
Entity type:Organization
Organization Name:LAKEWOOD RANCH RETINA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:ROHOWETZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-312-1091
Mailing Address - Street 1:10910 NW 8TH CT
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-7352
Mailing Address - Country:US
Mailing Address - Phone:941-312-1091
Mailing Address - Fax:
Practice Address - Street 1:10910 NW 8TH CT
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-7352
Practice Address - Country:US
Practice Address - Phone:941-312-1091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-19
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Single Specialty