Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Lake Surgical Clinic PA

Organization Specialist · NPI 1114105442

Lake Surgical Clinic PA provides Specialist services 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 Not confirmed with CMS for 16 years — call before visiting
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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