# LAKE COUNTY ONCOLOGY AND HEMATOLOGY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518923408
- **Authorized official:** ROY M AMBINDER M. D. (PRESIDENT)
- **Authorized official phone:** (386) 774-5211

## Contact information

- **Practice address:** 4100 WATERMAN WAY, TAVARES, FL 32778-5270
- **Practice address phone:** (386) 774-5211
- **Practice address fax:** (386) 774-5251
- **Mailing address:** PO BOX 741240, ORANGE CITY, FL 32774-1240
- **Mailing address phone:** (386) 774-5211
- **Mailing address fax:** (386) 774-5251

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RH0003X | Hematology & Oncology Physician | 06000041448 | FL | Yes |

## Other

- **Enumeration date:** 04/21/2006
- **Last updated:** 04/13/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 258998200 | — | FL |