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26540 Ace Ave Suite 108 Leesburg FL 34748-8279 | |
| (352) 787-5617 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 26540 Ace Ave, Leesburg, Florida |
| Authorized Official Name and Position | June K Lew (ADMINISTRATOR) |
| Authorized Official Contact | 3527286808 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
511 Medical Plaza Dr Suite 101 Leesburg FL 34748-7326 Ph: (352) 728-6808 | 26540 Ace Ave Suite 108 Leesburg FL 34748-8279 Ph: (352) 787-5617 |
| NPI Number | 1578766119 |
|---|---|
| Provider Enumeration Date | 06/11/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578766119 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME 55553 (Florida) | Primary |
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