Lake Pediatrics, P.A.
LBN: Lake Pediatrics P. A.
Lake Pediatrics, P.A. is an health care organization with primary practice located at 4880 N Hwy 19 A , Mt Dora FL 32757-2018. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Ambulatory Health Care Facilities / Rural Health. Allopathic & Osteopathic Physicians / Pediatrics is the primary health care specialty.
Lake Pediatrics P. A. can be contacted via phone (352) 589-8111, or through Nettles, Donna Lynn via phone (523) 638-4997.
Contact Information
Primary practice address
4880 N Hwy 19 A
Mt Dora FL 32757-2018
Phone: (352) 589-8111
Fax: (352) 589-8111
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ||
| Ambulatory Health Care Facilities / Rural Health | 261QR1300X |
Profile Details
| NPI number | 1942367370 |
|---|---|
| LBN Legal business name | Lake Pediatrics P. A. |
| DBA Doing business as | Lake Pediatrics, P.A. |
| Authorized official | Nettles, Donna Lynn |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 3rd, 2007 |
| Last updated | Jan 11th, 2022 - about 3 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942367370 | NPPES |
| Florida | MEDICAID | 660103100 |
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