Individual
MRS. MARY ALICE-SPARKS LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1000 WATERMAN WAY, TAVARES, FL 32778-5266
(352) 742-3578
Mailing address
1741 DAVID WALKER DR, TAVARES, FL 32778-5745
(352) 742-3578
(352) 742-3581
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ME106438
FL
208M00000X
Hospitalist Physician
Primary
ME106438
FL
Other
Enumeration date
05/03/2010
Last updated
07/21/2022
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