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Lake Neurology Clinic, P.a.
Specialist in Leesburg, Florida
NPI 1700958600

Lake Neurology Clinic, P.a. is a Specialist based in Leesburg, FL. Lake Neurology Clinic, P.a. practices in Leesburg, FL. The NPI Number for Lake Neurology Clinic, P.a. is 1700958600 and holds a License No. ME76490 (Florida).

The current practice location address for Lake Neurology Clinic, P.a. is 608 S 9Th Street, Leesburg, FL and can be reached out via phone at 352-360-1122 and via fax at 352-360-1123.

Location: 608 S 9Th Street, Leesburg, FL, 34749-0123
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1700958600
Provider Name
Lake Neurology Clinic, P.a.
Credential
Provider Entity Type
Organization
Address
608 S 9Th Street, Leesburg, FL, 34749-0123
Phone Number
352-360-1122
Fax Number
352-360-1123
Provider Enumeration Date
11/15/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
130025175 01 FL MEDICARE RAILROAD
44751 01 FL BCBS
257303200 05 FL
institution
Provider Business Practice Location Address Details
Address
608 S 9Th Street
City
Leesburg
State
Florida
Zip
34748
Phone Number
352-360-1122
Fax Number
352-360-1123
person
Provider Business Mailing Address Details
Address
608 S 9Th Street
City
Leesburg
State
Florida
Zip
34748
Phone Number
352-360-1122
Fax Number
352-360-1123
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
ME76490 (Florida)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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