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General NPI Number Information
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NPI Number | 1831369792
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Entity Type | Organization
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Legal Business Name | LAKE COUNTY NEUROSURGICALAND SPINAL INSTITUTE
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Dates
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Enumeration Date | 03/07/2008
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Last Update Date | 05/29/2013
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Provider Practice Location Address
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Address Line | 704 DOCTORS CT SUITE 101
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City | LEESBURG
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State | FL
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Zip | 34748-7366
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Country | US
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Telephone | 352-728-3252
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Fax | 352-728-1320
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Provider Business Mailing Address
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Address Line | 704 DOCTORS CT SUITE 101
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City | LEESBURG
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State | FL
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Zip | 34748-7366
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Country | US
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Telephone | 352-728-3252
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Fax | 352-728-1320
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL G. HILL
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Credential | M.D.
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Telephone | 352-728-3252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | ME68960
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License Number State | FL
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