Lake Internal Medicine PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LAKE INTERNAL MEDICINE PA

Practice address

293 Bent Oak CT
Leesburg, FL 34748-9559

Phone

(352) 408-9935

NPI assigned

Jul 20, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nage Kha

Title

President

Phone

(352) 408-9935

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1374278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401235200000",
    "number": "1013359975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "293 BENT OAK CT",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347489559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "293 BENT OAK CT",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347489559",
            "telephone_number": "352-408-9935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE INTERNAL MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-20",
        "last_updated": "2014-05-28",
        "status": "A",
        "authorized_official_last_name": "KHA",
        "authorized_official_first_name": "NAGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-408-9935"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Leesburg, FL
• Providers in Leesburg, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.