Lakeland Health Care Associates LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF130470996 Issued in FL

Legal business name

LAKELAND HEALTH CARE ASSOCIATES LLC

Practice address

1010 Carpenters Way
Lakeland, FL 33809-3926

Phone

(863) 815-0488

Fax

(863) 815-0580

NPI assigned

May 26, 2006

Organization subpart

No

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

Authorized official

Name

Alexander J. Kusmierz

Title

Manager

Phone

(863) 815-0488

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wedgewood Healthcare Center Doing business as

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353456000000",
    "number": "1083660427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 CARPENTERS WAY",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338093926",
            "telephone_number": "863-815-0488",
            "fax_number": "863-815-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 CARPENTERS WAY",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338093926",
            "telephone_number": "863-815-0488",
            "fax_number": "863-815-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND HEALTH CARE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2012-11-21",
        "status": "A",
        "authorized_official_last_name": "KUSMIERZ",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "863-815-0488"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF130470996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025232800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wedgewood Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lakeland Family Pharmacy
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• Lakeland Foot & Ankle Center PA
• Lakeland Hills Medical Center
• Lakeland Hills Rehabilitation Center, LLC
• Lakeland Institute for Learning Org Corp
• Lakeland Institute of Learning Inc
• Lakeland Investors LLC

• Skilled Nursing Facility in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; 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.