Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Lubomyr Lazor Mutis, SA-C, IMG

Individual provider Surgical Assistant · NPI 1306467790

Lubomyr Lazor Mutis, SA-C, IMG is a Surgical Assistant in Groveland, Florida. Practices as a sole proprietor. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2020
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Practice location Address checks out

5963 Churchill Square Way
Groveland, FL 34736-3128
Phone: (407) 927-0778
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Assistant (primary) Taxonomy 246ZC0007X · Licence 19543 (WI)

Record details

NPI number1306467790
Entity typeIndividual (Type 1)
GenderMale
Credentials SA-C , IMG
Sole proprietorYes
NPI enumeratedApril 27, 2020
Last updated in NPPESApril 27, 2020
Certification dateApril 27, 2020

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