| Dr Beverly A Lense, MD | |
|
1502 N Donnelly St Ste 103, Mount Dora, FL 32757-2846 | |
| (352) 383-0624 | |
| (352) 383-0758 |
| Full Name | Dr Beverly A Lense |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 1502 N Donnelly St Ste 103, Mount Dora, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558352468 | NPI | - | NPPES |
| 252564000 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | ME116906 (Florida) | Primary |
| Entity Name | Physician Associates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336137280 PECOS PAC ID: 0244135093 Enrollment ID: O20031204000591 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Beverly A Lense, MD 4137 Hunters Park Ln, Orlando, FL 32837-7669 Ph: (407) 261-2934 | Dr Beverly A Lense, MD 1502 N Donnelly St Ste 103, Mount Dora, FL 32757-2846 Ph: (352) 383-0624 |
Rezia Catherine Shobhana Divaker, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 6551 N Orange Blossom Trl, Ste# 229, Mount Dora, FL 32757 Phone: 352-383-8384 | |
Dr. Samuel S Divaker, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 6551 N Orange Blossom Trl Ste 229, Mount Dora, FL 32757 Phone: 352-383-8384 Fax: 678-553-0329 | |
Dr. Lorraine Noreen Mitchell, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1502 N Donnelly St Ste 103, Mount Dora, FL 32757 Phone: 352-383-0624 | |
Liliane Kovacs Lesmes, MD FAAP Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 4880 N Highway 19a, Mount Dora, FL 32757 Phone: 352-589-8111 Fax: 352-589-8495 | |
Michael Curtis Baker, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1502 N Donnelly St, Ste 103, Mount Dora, FL 32757 Phone: 352-383-0624 Fax: 352-383-0758 |