LAKE CANCER MEDICAL CENTER PA
Osteopathic Medicine in Leesburg, FL

License number
Florida ME81152
Category
Medical Practice
Type
Specialist
License number
Florida ME80262
Category
Osteopathic Medicine
Type
Hematology & Oncology
License number
Florida ME24875
Category
Osteopathic Medicine
Type
Hematology & Oncology
Owner
Name: MRS. LOURDES M MATHEW MD
Title: MD
Phone: (352) 728-2532
Address
Address
732 NORTH Third St, Leesburg, FL 34748
National Provider ID: 1093747560
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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LAKE CANCER MEDICAL CENTER, PA

732 N 3 St, Leesburg, FL 34748

Industry:
Internist
Registration:
Nov 9, 2004
Phone:
(352) 728-2532 (Phone)
State ID:
P04000153377
Business type:
Florida Profit Corporation
S:
Lourdes M Mathew, 732 N 3 St, Leesburg, FL 34748 (Physical),Pablo Reyes, 732 N 3 St, Leesburg, FL 34748 (Physical)
Agent:
Lourdes Mathew,732 N 3 St, Leesburg, FL 34748 (Physical)
EIN:
201858776

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