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Organization

INFECTIOUS DISEASE OF LAKE COUNTY,LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
YULISA ASTUDILLO APRN (MANAGER)
(352) 835-2391
Entity
Organization

Contact information

Practice address
2050 CLASSIQUE LN, TAVARES, FL 32778-5787
(352) 835-2391
Mailing address
2050 CLASSIQUE LN, TAVARES, FL 32778-5787

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary

Other

Enumeration date
02/25/2019
Last updated
02/25/2019
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