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312 S Lake St Leesburg FL 34748-5920 | |
| (973) 204-4727 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 312 S Lake St, Leesburg, Florida |
| Authorized Official Name and Position | Arthur E Nwaubani (OWNER) |
| Authorized Official Contact | 9732044727 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 490950 Leesburg FL 34749-0950 Ph: (973) 204-4727 | 312 S Lake St Leesburg FL 34748-5920 Ph: (973) 204-4727 |
| NPI Number | 1144663162 |
|---|---|
| Provider Enumeration Date | 04/09/2013 |
| Last Update Date | 04/09/2013 |
| Medicare PECOS PAC ID | 5890910244 |
|---|---|
| Medicare Enrollment ID | O20140627001334 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144663162 | NPI | - | NPPES |
| Provider Name | Arthur E Nwaubani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679748107 PECOS PAC ID: 5799900148 Enrollment ID: I20140627001417 |
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