Organization
LAKE CARDIOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH DAVID KRONHAUS MD (PRESIDENT)
(352) 735-1400
Entity
Organization
Contact information
Practice address
250 EAST FOURTH AVENUE, MOUNT DORA, FL 32757-5536
(352) 735-1400
(352) 735-3300
Mailing address
250 EAST FOURTH AVENUE, MOUNT DORA, FL 32757-5536
(352) 735-1400
(352) 735-3300
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
057697200
—
FL
Enumeration date
09/22/2006
Last updated
10/09/2009
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