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Organization
NEPHROLOGY ASSOCIATES OF LAKE COUNTY LLC
Active
Organization
NEPHROLOGY ASSOCIATES OF LAKE COUNTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNE LYNN STAVES (OFFICE MANAGER)
(352) 383-1245
Entity
Organization
Contact information
Practice address
3801 N HIGHWAY 19A, SUITE 400, MOUNT DORA, FL 32757-2228
(352) 383-1245
(352) 383-4401
Mailing address
3801 N HIGHWAY 19A, SUITE 400, MOUNT DORA, FL 32757-2228
(352) 383-1245
(352) 383-4401
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
02/11/2011
Last updated
02/11/2011
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