| NPI | 1518631811 |
|---|---|
| Doing Business As | LAKE PEDIATRICS P.A. |
| Entity Type | Organization |
| Authorized Contact | DONNA LYNN NETTLES Billing Manager 352-638-4997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2021-08-02 |
| Last Update Date | 2025-10-13 |