Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lake Neurology Clinic, PA

Organization Specialist · NPI 1700958600

Lake Neurology Clinic, PA is a Specialist in Leesburg, Florida. Licensed in Florida. Registered with an NPI since 2006.

Licensed in
FL
In the registry since
2006
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

608 S 9th St Ste A
Leesburg, FL 34748
Phone: (352) 360-1122
Fax: (352) 360-1123
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence ME76490 (FL)

Record details

NPI number1700958600
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Marilyn Glover — Office Manager · (352) 360-1122
NPI enumeratedNovember 15, 2006
Last updated in NPPESMarch 5, 2010
Mailing addressPo Box 490123, Leesburg, FL 34749-0123

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