EAR, NOSE & THROAT ASSOCIATES OF LAKE COUNTY , PA
Medical Practice at Classique Ln, Tavares, FL

License number
Florida ME0054256
Category
Medical Practice
Type
Otolaryngology
Owner
Name: DON S. BURGOS MD
Title: DOCTOR
Phone: (352) 742-0225
Address
Address
2038 Classique Ln, Tavares, FL 32778
National Provider ID: 1639372634
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Ear, Nose & Throat Associates of Lake County, PA

Eustis, FL  -  Tavares, FL

Registration:
Jan 1, 1979
Addresses:
1140 S Grv St, Eustis, FL 32726
2038 Classique Ln, Tavares, FL 32778
State ID:
605776
Business type:
Domestic for Profit Corporation
President, Treasurer, Director:
S. Burgos (President, Treasurer, Director)
Agent:
Jeffrey M. Koltun

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