1316244296 NPI number — NEPHROLOGY ASSOCIATES OF LAKE COUNTY LLC

Table of content: DR. WILLIAM DAVID HUFF MD (NPI 1922060771)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316244296 NPI number — NEPHROLOGY ASSOCIATES OF LAKE COUNTY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEPHROLOGY ASSOCIATES OF LAKE COUNTY LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316244296
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/11/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3801 N HIGHWAY 19A
Provider Second Line Business Mailing Address:
SUITE 400
Provider Business Mailing Address City Name:
MOUNT DORA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32757-2228
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-383-1245
Provider Business Mailing Address Fax Number:
352-383-4401

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3801 N HIGHWAY 19A
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
MOUNT DORA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32757-2228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-383-1245
Provider Business Practice Location Address Fax Number:
352-383-4401
Provider Enumeration Date:
02/11/2011

Additional Information

Authorized Official

Authorized Official Last Name:
STAVES
Authorized Official First Name:
SUZANNE
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
352-383-1245

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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