Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Benjamin Tyler Lack

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1851188692

Benjamin Tyler Lack is a Student in an Organized Health Care Education/Training Program in Gainesville, Florida. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone: (352) 265-0111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1851188692
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 24, 2025
Last updated in NPPESJune 9, 2026
Certification dateJune 9, 2026
Mailing address1600 Sw Archer Rd, Gainesville, FL 32610-3003

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