Organization
LAKE CANCER & HEMATOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOURDES M MATHEW MD (OWNER)
(352) 728-2532
Entity
Organization
Contact information
Practice address
732 N 3RD ST, LEESBURG, FL 34748-4442
(352) 728-2532
(352) 728-3004
Mailing address
732 N 3RD ST, LEESBURG, FL 34748-4442
(352) 728-2532
(352) 728-3004
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME24875
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
056387100
—
FL
Enumeration date
06/11/2014
Last updated
06/11/2014
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