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Organization
PATHOLOGY SERVICES ALLIANCE LLC
Active
Organization
PATHOLOGY SERVICES ALLIANCE LLC
Active
Parent organization
LEESBURG REGIONAL MEDICAL CENTER, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
LEESBURG REGIONAL MEDICAL CENTER, INC.
Authorized official
MRS. DIANE HARDEN (CHIEF FINANCIAL OFFICER)
(352) 323-5002
Entity
Organization
Contact information
Practice address
732 N 3RD ST, LEESBURG, FL 34748-4442
(352) 787-1778
(352) 787-1164
Mailing address
1456 WILLIAM ST, ATTN: LORETTA ROSENBALM, LEESBURG, FL 34748-3824
(352) 787-1778
(352) 787-1164
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
NULL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
08/24/2009
Last updated
12/07/2020
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