Individual
DR. LOVELL LEONARD MAYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17000 PORTER RD, WINTER GARDEN, FL 34787-8915
(321) 842-5052
Mailing address
15705 PANTHER LAKE DR, WINTER GARDEN, FL 34787-4567
(352) 223-0061
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
ME59012
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11640
BLUE CROSS BLUE SHIELD
FL
05
—
271321700
—
FL
Enumeration date
08/31/2006
Last updated
11/20/2023
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