Organization
LAKE NONA SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. REY ESTEVAN (MGR)
(352) 622-4251
Entity
Organization
Contact information
Practice address
6424 ALEXANDRA LOUISE DR STE 400, ORLANDO, FL 32827-5810
(407) 610-6648
(855) 719-2579
Mailing address
6424 ALEXANDRA LOUISE DR STE 400, ORLANDO, FL 32827-5810
(407) 610-6648
(855) 719-2579
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH35954
LICENSE
FL
Enumeration date
11/12/2025
Last updated
12/16/2025
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