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General NPI Number Information
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NPI Number | 1255545349
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Entity Type | Organization
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Legal Business Name | LAKE MEDICAL BILLING SERVICES INC
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 340 W OAK TERRACE DR SUITE 107
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City | LEESBURG
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State | FL
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Zip | 34748-4457
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Country | US
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Telephone | 352-326-9638
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Fax | 352-326-9683
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Provider Business Mailing Address
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Address Line | 1106 TEAL LN
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City | LADY LAKE
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State | FL
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Zip | 32159-5149
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Country | US
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Telephone | 352-326-9638
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Fax | 352-326-9683
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Authorized Official
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Title or Position | OWEN
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Name | WILLIAM S MCPHERSON
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Credential | RT
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Telephone | 352-326-9638
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number | TT0009233
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License Number State | FL
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