Organization
LAKE COUNTY ONCOLOGY AND HEMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROY M AMBINDER M. D. (PRESIDENT)
(386) 774-5211
Entity
Organization
Contact information
Practice address
4100 WATERMAN WAY, TAVARES, FL 32778-5270
(386) 774-5211
(386) 774-5251
Mailing address
PO BOX 741240, ORANGE CITY, FL 32774-1240
(386) 774-5211
(386) 774-5251
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
06000041448
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
258998200
—
FL
Enumeration date
04/21/2006
Last updated
04/13/2012
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