Organization
LAKE EMERGENCY MEDICAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WELTON G. CADWELL (BOARD CHAIRMAN)
(352) 343-9850
Entity
Organization
Contact information
Practice address
2761 WEST OLD HIGHWAY 441, MOUNT DORA, FL 32757
(352) 383-4554
(352) 385-9063
Mailing address
2761 WEST OLD HIGHWAY 441, MOUNT DORA, FL 32757
(352) 383-4554
(352) 385-9063
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
ALS3503
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004071400
—
FL
Enumeration date
08/09/2011
Last updated
01/18/2012
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