Organization
LAKE PEDIATRICS P. A.
Active
Other names
Lake Pediatrics P.A.
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA LYNN NETTLES (BILLING MANAGER)
(352) 638-4997
Entity
Organization
Contact information
Practice address
4880 N HIGHWAY 19A, MOUNT DORA, FL 32757-2018
(352) 589-8111
(352) 589-8495
Mailing address
4880 N HIGHWAY 19A, MOUNT DORA, FL 32757-2018
(352) 589-8111
(352) 589-8495
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
08/02/2021
Last updated
10/13/2025
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