Organization
NEPHROLOGY ASSOCIATES OF LAKE COUNTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNE LYNN STAVES (OFFICE MANAGER)
(352) 383-1245
Entity
Organization
Contact information
Practice address
3801 N HIGHWAY 19A, SUITE 400, MOUNT DORA, FL 32757-2228
(352) 383-1245
(352) 383-4401
Mailing address
3801 N HIGHWAY 19A, SUITE 400, MOUNT DORA, FL 32757-2228
(352) 383-1245
(352) 383-4401
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
02/11/2011
Last updated
02/11/2011
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