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Lake Dermatology Pa
Medical Specialty Clinic/Center in Leesburg, Florida
NPI 1598843914

Lake Dermatology Pa is a Medical Specialty Clinic/Center based in Leesburg, FL and is specialized in Medical Specialty. Lake Dermatology Pa practices in Leesburg, FL. The NPI Number for Lake Dermatology Pa is 1598843914 and holds a License No. ME64096 (Florida).

The current practice location address for Lake Dermatology Pa is 1132 E North Blvd, Leesburg, FL and can be reached out via phone at 352-365-6650 and via fax at 352-365-0932.

Location: 1132 E North Blvd, Leesburg, FL, 34748-5350
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1598843914
Provider Name
Lake Dermatology Pa
Credential
Provider Entity Type
Organization
Address
1132 E North Blvd, Leesburg, FL, 34748-5350
Phone Number
352-365-6650
Fax Number
352-365-0932
Provider Enumeration Date
11/02/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
1132 E North Blvd
City
Leesburg
State
Florida
Zip
34748-5350
Phone Number
352-365-6650
Fax Number
352-365-0932
person
Provider Business Mailing Address Details
Address
1132 E North Blvd
City
Leesburg
State
Florida
Zip
34748-5350
Phone Number
352-365-6650
Fax Number
352-365-0932
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
ME64096 (Florida)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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