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Organization
LAKE INTERNAL MEDICINE ASSOCIATES
Active
Organization
LAKE INTERNAL MEDICINE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE L DEMUTH (PRACTICE MANAGER)
(352) 589-4774
Entity
Organization
Contact information
Practice address
2101 PREVATT ST, EUSTIS, FL 32726-6131
(352) 589-4774
(352) 589-5092
Mailing address
2101 PREVATT ST, EUSTIS, FL 32726-6131
(352) 589-4774
(352) 589-5092
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/25/2006
Last updated
09/19/2024
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