NPIMap

Organization Active NPI

Lakeland Eye Clinic PA

  • Ophthalmology Physician
  • Lakeland, FL
National Provider Identifier
1154414159
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
LAKELAND EYE CLINIC PA
Practice address
1247 Lakeland Hills Blvd
Lakeland, FL 33805-4673
Phone
(863) 688-5604
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Authorized official

Name
Kevin A Dorsett, MD
Title
President
Phone
(863) 688-5604

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1247 Lakeland Hills Blvd
Lakeland, FL 33805-4673

Mailing address

1247 Lakeland Hills Blvd
Lakeland, FL 33805-4673
Phone (863) 688-5604

Other practice location 1

4708 S Florida Ave
Lakeland, FL 33813-2165
Phone (863) 688-5604

Other practice location 2

1243 Lakeland Hills Blvd
Lakeland, FL 33805-4673
Phone (863) 262-3111

Other names 1

  • Lakeland Eye Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

6743 US Highway 98 N
Lakeland, FL 33809
Phone (863) 858-2020

Interoperability endpoints

  • Direct secure messaging: aschneider@laec.intellechartdirect.net
  • Direct secure messaging: jryder@laec.intellechartdirect.net
  • Direct secure messaging: jliechty@laec.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 3

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": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663113600000",
    "number": "1154414159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1247 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054673",
            "telephone_number": "863-688-5604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1247 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054673",
            "telephone_number": "863-688-5604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4708 S Florida Ave",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338132165",
            "country_code": "US",
            "telephone_number": "863-688-5604",
            "fax_number": "863-682-6052",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1243 Lakeland Hills Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338054673",
            "country_code": "US",
            "telephone_number": "863-262-3111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAKELAND EYE CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-02",
        "status": "A",
        "authorized_official_last_name": "DORSETT",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-688-5604",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeland Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lakeland Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; 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.