Lake Surgical Clinic PA

NPI #1114105442 in Leesburg, Florida

Provider Information

NPI Number: 1114105442
Entity Type: Organization
Organization Name: Lake Surgical Clinic PA
Primary Specialty: Specialist
Enumeration Date: Feb 8, 2008
Last Updated: Aug 17, 2010

Practice Location

Address: 1111 W DIXIE AVE
City: Leesburg
State: Florida
ZIP Code: 34748-6386
Phone: (352) 787-8230

Authorized Official

Name: DR. DAVID W BURNSED, M.D.
Title: OWNER
Phone: (352) 787-8230

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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