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General NPI Number Information
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NPI Number | 1235165531
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Entity Type | Organization
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Legal Business Name | LAKE SURGERY & ENDOSCOPY CENTER LTD
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 01/09/2014
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Provider Practice Location Address
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Address Line | 8110 COUNTY ROAD 44 LEG A
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City | LEESBURG
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State | FL
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Zip | 34788-3704
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Country | US
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Telephone | 352-323-8868
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Fax | 352-323-1691
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Provider Business Mailing Address
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Address Line | 8110 CNTY RD 44 8110 COUNTY ROAD 44, LEG A
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City | LEESBURG
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State | FL
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Zip | 34788-3704
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Country | US
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Telephone | 352-323-8868
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Fax | 352-728-5497
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Authorized Official
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Title or Position | DOCTOR
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Name | LILY TRAN
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Credential | M.D
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Telephone | 352-323-8868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 845
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License Number State | FL
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