Organization Active NPI

To Your Health of Lake County Inc

  • Internal Medicine Physician
  • Leesburg, FL
National Provider Identifier
1104017946
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME70698 Issued in FL
Legal business name
TO YOUR HEALTH OF LAKE COUNTY INC
Practice address
26540 Ace Ave
Suite 108C
Leesburg, FL 34748-8279
Phone
(352) 326-5281
Fax
(352) 323-1761
NPI assigned
Aug 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2011

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

Authorized official

Name
Dr. Joseph L Carrasco, M.D.NPI 1174610067
Title
Owner
Phone
(352) 326-5281

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME70698 FL Primary

Addresses

Primary practice location

26540 Ace Ave
Suite 108C
Leesburg, FL 34748-8279

Mailing address

26540 Ace Ave
Suite 108C
Leesburg, FL 34748-8279
Phone (352) 326-5281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080222000360 FL Part B Supplier - Clinic/Group Practice 3678657129 Receives reassigned benefits from 7 practitioners
Practice locations: Leesburg, FL

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

26540 Ace Ave
Ste D
Leesburg, FL 34748
Phone (352) 989-7339

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318291200000",
    "number": "1104017946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26540 ACE AVE",
            "address_2": "SUITE 108C",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347488279",
            "telephone_number": "352-326-5281",
            "fax_number": "352-323-1761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26540 ACE AVE",
            "address_2": "SUITE 108C",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347488279",
            "telephone_number": "352-326-5281",
            "fax_number": "352-323-1761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TO YOUR HEALTH OF LAKE COUNTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2011-10-11",
        "status": "A",
        "authorized_official_last_name": "CARRASCO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-326-5281",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME70698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.