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

Lake Surgical Clinic PA

Organization Specialist · NPI 1114105442

Lake Surgical Clinic PA is a Specialist in Leesburg, Florida. Licensed in Florida. Registered with an NPI since 2008.

Licensed in
FL
In the registry since
2008
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

1111 W Dixie Ave
Leesburg, FL 34748-6386
Phone: (352) 787-8230
Fax: (352) 787-6964
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence ME16817 (FL)

Record details

NPI number1114105442
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official David Burnsed — Owner · (352) 787-8230
NPI enumeratedFebruary 8, 2008
Last updated in NPPESAugust 17, 2010
Mailing address1111 W Dixie Ave, Leesburg, FL 34748-6386

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