NPIMap

Organization Active NPI

Medical Ventures of America LLC

Doing business as Lake Regional Urgent Care

  • Legal Medicine
  • Mount Dora, FL
National Provider Identifier
1073576146
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
Legal business name
MEDICAL VENTURES OF AMERICA LLC
Doing business as
Lake Regional Urgent Care
Practice address
16890 US Highway 441
Mount Dora, FL 32757-6705
Phone
(352) 250-5546
NPI assigned
Apr 10, 2006
Last updated
Mar 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Authorized official

Name
Mark Delegge, MD
Title
Owner
Phone
(843) 697-0400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal MedicineGroup: 193400000X SINGLE SPECIALTY GROUP 173000000X Primary

Addresses

Primary practice location

16890 US Highway 441
Mount Dora, FL 32757-6705

Mailing address

16890 US Highway 441
Mount Dora, FL 32757-6705
Phone (352) 250-5546

Other identifiers 4

IdentifierTypeStateIssuer
10D1004910OtherFLMEDICARE CLIA #
34537OtherFLBLUE GRP PROV #
B902BOtherFLBLUE SHIELD FACILITY #
266435600MedicaidFL

Other names 1

  • LAKE REGIONAL URGENT CARE Doing business as

National Provider Directory

National Provider Directory

Locations

910 Old Camp Rd
Ste 114
The Villages, FL 32162
Phone (352) 259-4322

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1073576146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16890 US HIGHWAY 441",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576705",
            "telephone_number": "352-250-5546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16890 US HIGHWAY 441",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576705",
            "telephone_number": "352-250-5546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL VENTURES OF AMERICA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "DELEGGE",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-697-0400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CLIA #",
            "identifier": "10D1004910",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE GRP PROV #",
            "identifier": "34537",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD FACILITY #",
            "identifier": "B902B",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266435600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAKE REGIONAL URGENT CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Dora, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; 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.