Lake Ent & Fps, PA

NPI #1629091996 in Leesburg, Florida

Provider Information

NPI Number: 1629091996
Entity Type: Organization
Organization Name: Lake Ent & Fps, PA
Primary Specialty: Specialist
Enumeration Date: Jul 26, 2006
Last Updated: Oct 2, 2020

Practice Location

Address: 601 E DIXIE AVE
Address 2: PLAZA 901
City: Leesburg
State: Florida
ZIP Code: 34748-5953
Phone: (352) 728-2404

Authorized Official

Name: JUDITH C MILSTEAD, M.D.
Title: PRESIDENT
Phone: (352) 728-2404

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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