Organization
LAKE UROLOGY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FOUAD M SHAMI M.D. (PARTNER)
(352) 787-4567
Entity
Organization
Contact information
Practice address
616 N PALMETTO ST, LEESBURG, FL 34748-4417
(352) 787-4567
(352) 787-0370
Mailing address
616 N PALMETTO ST, LEESBURG, FL 34748-4417
(352) 787-4567
(352) 787-0370
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
07/30/2006
Last updated
09/28/2007
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