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Organization

LAKE SUMTER UROLOGY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VENKATA MARELLA MD (OWNER AND AO)
(352) 775-6899
Entity
Organization

Contact information

Practice address
808 HIGHWAY 466, LADY LAKE, FL 32159-3918
(352) 775-6899
(877) 319-1879
Mailing address
808 HIGHWAY 466, LADY LAKE, FL 32159-3918
(352) 775-6899
(877) 319-1879

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary

Other

Enumeration date
01/11/2022
Last updated
11/22/2023
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