Flower of the Lake Family Practice PA

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

OS6731 Issued in FL

Legal business name

FLOWER OF THE LAKE FAMILY PRACTICE PA

Practice address

720 N Bay St
Suite 5
Eustis, FL 32726-2964

Phone

(352) 357-7200

Fax

(352) 357-7100

NPI assigned

Dec 10, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Margaret Hayden, DO

Title

President

Phone

(352) 357-7200

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281916800000",
    "number": "1023347648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 N BAY ST",
            "address_2": "SUITE 5",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327262964",
            "telephone_number": "352-357-7200",
            "fax_number": "352-357-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 N BAY ST",
            "address_2": "SUITE 5",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327262964",
            "telephone_number": "352-357-7200",
            "fax_number": "352-357-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLOWER OF THE LAKE FAMILY PRACTICE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-10",
        "last_updated": "2010-08-16",
        "status": "A",
        "authorized_official_last_name": "HAYDEN",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-357-7200",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "OS6731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce Robert Fisher, COTA
• Jeannette J Fisher
• Florida Department of Health
• Florida First Care, Inc.
• Florida Physical Therapy & Wellness Ctr LLC
• Flower of the Lake Family Practice, PA
• Floyd S Dillard MD PA
• Brittany Forbes
• Vance Forde
• David Forster

• Clinic/Center in Eustis, FL
• Providers in Eustis, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; 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.