LAKE SUMTER UROLOGY LLC NPI 1285385401

NPI Information

  • NPI: 1285385401
  • Provider Name: LAKE SUMTER UROLOGY, LLC
  • Classification: Urology - 208800000X
  • Entity Type: Organization
  • CLIA Number: 10D2283164
  • Address: 808 HIGHWAY 466
    LADY LAKE, FL
    ZIP 32159
  • Phone: (352) 775-6899

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NPI Details

LAKE SUMTER UROLOGY, LLC is an urology in Lady Lake, FL. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. LAKE SUMTER UROLOGY, LLC NPI is 1285385401. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

808 HIGHWAY 466
LADY LAKE, FL
ZIP 32159-918
Phone: (352) 775-6899
Fax: (877) 319-1879

The provider's authorized official is Venkata Marella .
The authorized official title is Owner And Ao and has the following contact phone number (352) 775-6899.

The CLIA number assigned to this NPI record is 10D2283164 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 1/11/2022 and was last updated on 11/22/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208800000XUrologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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