LAKE NEUROLOGY CLINIC, P.A.
NPI 1700958600
Specialist in Leesburg, FL

Q: What is Lake Neurology Clinic, P.A.'s NPI number?

The NPI number for Lake Neurology Clinic, P.A. is 1700958600. It was assigned to this organization in the NPPES registry on November 15, 2006.

Q: What is Lake Neurology Clinic, P.A.'s specialty?

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

Active since November 15, 2006

608 S 9TH STREET, STE A, LEESBURG, FL 34748(352) 360-1122(352) 360-1123 Get Directions Write a Review

NPPES record last updated: March 5, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Lake Neurology Clinic, P.a. NPPES

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

LAKE NEUROLOGY CLINIC, P.A. (NPI 1700958600) is a healthcare organization registered as a specialist in Leesburg, Florida and active in the NPI registry since November 2006. The organization lists Marilyn C Glover, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1700958600

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NameLAKE NEUROLOGY CLINIC, P.A.

Location Address608 S 9TH STREET, STE ALeesburg, FL 34748

Mailing AddressPo Box 490123Leesburg, FL 34749-0123 · (352) 360-1122 · Fax (352) 360-1123

Phone(352) 360-1122

Fax(352) 360-1123

Organization SubpartNo

Authorized OfficialMarilyn C GloverOffice Manager · (352) 360-1122

Enumeration DateNovember 15, 2006

Last NPPES UpdateMarch 5, 2010

✔ NPI 1700958600 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in FL · ME76490

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.

608 S 9TH STREET, Leesburg, FL 34748

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Other Identifiers 6

Medicare PINK3655FL

Medicare UPING83844FL

Medicare ID-Type UnspecifiedE1265XFL

Other44751FL · Bcbs

Medicaid257303200FL

Other130025175FL · Medicare Railroad

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 Neurology Clinic, P.A.'s NPI number?

The NPI number for Lake Neurology Clinic, P.A. is 1700958600. It was assigned to this organization in the NPPES registry on November 15, 2006.

Where is Lake Neurology Clinic, P.A. located?

Lake Neurology Clinic, P.A. is located at 608 S 9th Street Ste A, Leesburg, FL 34748. The listed phone number is (352) 360-1122.

What is Lake Neurology Clinic, P.A.'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 Neurology Clinic, P.A. was last updated on March 5, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.