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LAKE SURGICAL CLINIC PA
NPI 1114105442
Specialist in Leesburg, FL

Active since February 08, 2008
1111 W DIXIE AVE, LEESBURG, FL 34748(352) 787-8230(352) 787-6964 Get Directions Write a Review

NPPES record last updated: August 17, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lake Surgical Clinic Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE SURGICAL CLINIC PA (NPI 1114105442) is a healthcare organization registered as a specialist in Leesburg, Florida and active in the NPI registry since February 2008. The organization lists David W Burnsed, Owner, as its authorized official.

NPPES Registry Identity

NPI1114105442
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameLAKE SURGICAL CLINIC PA
Location Address1111 W DIXIE AVELeesburg, FL 34748-6386
Mailing Address1111 W Dixie AveLeesburg, FL 34748-6386 · (352) 787-8230 · Fax (352) 787-6964
Phone(352) 787-8230
Fax(352) 787-6964
Organization SubpartNo
Authorized OfficialDavid W BurnsedOwner · (352) 787-8230
Enumeration DateFebruary 8, 2008
Last NPPES UpdateAugust 17, 2010
✔ NPI 1114105442 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in FL · ME16817
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1111 W DIXIE AVE, Leesburg, FL 34748
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Other Identifiers 1

Medicare PINK0016FL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lake Surgical Clinic PA's NPI number?

The NPI number for Lake Surgical Clinic PA is 1114105442. It was assigned to this organization in the NPPES registry on February 8, 2008.

Where is Lake Surgical Clinic PA located?

Lake Surgical Clinic PA is located at 1111 W Dixie Ave, Leesburg, FL 34748. The listed phone number is (352) 787-8230.

What is Lake Surgical Clinic PA's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Lake Surgical Clinic PA was last updated on August 17, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.