| Internal Medicine Associates Of Lake County, P.a. | |
|
619 W Dixie Ave Leesburg FL 34748-2602 | |
| (352) 314-2424 | |
| (352) 314-3010 |
| Full Name | Internal Medicine Associates Of Lake County, P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 619 W Dixie Ave, Leesburg, Florida |
| Authorized Official Name and Position | Gregory Mark Brown (PRESIDENT) |
| Authorized Official Contact | 3523142424 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine Associates Of Lake County, P.a. 619 W Dixie Ave Leesburg FL 34748-2602 Ph: (352) 314-2424 | Internal Medicine Associates Of Lake County, P.a. 619 W Dixie Ave Leesburg FL 34748-2602 Ph: (352) 314-2424 |
| NPI Number | 1285611210 |
|---|---|
| Provider Enumeration Date | 12/30/2005 |
| Last Update Date | 04/02/2015 |
| Medicare PECOS PAC ID | 5193840262 |
|---|---|
| Medicare Enrollment ID | O20100913000757 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285611210 | NPI | - | NPPES |
| 45358 | Other | FL | BCBS OF FLORIDA |
| 259964300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Gregory Mark Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386647956 PECOS PAC ID: 6002931177 Enrollment ID: I20100913000784 |
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