Organization
LAKE ANESTHESIA CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LALBAHADUR S NAGABHAIRU M.D. (MEDICAL DIRECTOR)
(352) 636-6969
Entity
Organization
Contact information
Practice address
2130 VINDALE RD, TAVARES, FL 32778-5637
(353) 383-7777
(352) 383-8875
Mailing address
2060 N DONNELLY ST, MOUNT DORA, FL 32757-2824
(352) 383-7777
(352) 383-8875
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME63590
FL
Other
Enumeration date
04/08/2010
Last updated
04/08/2010
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