Lake Neurology Clinic, P.a.

NPI #1700958600 in Leesburg, Florida

Provider Information

NPI Number: 1700958600
Entity Type: Organization
Organization Name: Lake Neurology Clinic, P.a.
Primary Specialty: Specialist
Enumeration Date: Nov 15, 2006
Last Updated: Mar 5, 2010

Practice Location

Address: 608 S 9TH STREET
Address 2: STE A
City: Leesburg
State: Florida
ZIP Code: 34748
Phone: (352) 360-1122

Authorized Official

Name: MARILYN C GLOVER
Title: OFFICE MANAGER
Phone: (352) 360-1122

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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