Internal Medicine of Lake City PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

BB6375477 Issued in FL

Legal business name

INTERNAL MEDICINE OF LAKE CITY PA

Practice address

289 SW Stonegate Ter
Suite 104
Lake City, FL 32024-3456

Phone

(386) 755-1703

Fax

(386) 755-1744

NPI assigned

Oct 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Shammi K Bali, MD

Title

President

Phone

(386) 755-1703

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380499200000",
    "number": "1285822981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 SW STONEGATE TER",
            "address_2": "SUITE 104",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320243456",
            "telephone_number": "386-755-1703",
            "fax_number": "386-755-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 SW STONEGATE TER",
            "address_2": "SUITE 104",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320243456",
            "telephone_number": "386-755-1703",
            "fax_number": "386-755-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE OF LAKE CITY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2013-09-30",
        "status": "A",
        "authorized_official_last_name": "BALI",
        "authorized_official_first_name": "SHAMMI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-755-1703",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "BB6375477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ibw Group, LLC
• Infectious Diseases Consultants Madhuri Sankuratri MD LLC
• John Douglas Inselman, COTA
• Integrated Regional Laboratories Pathology Services, LLC
• Internal Medicine of Lake City , PA
• Luisa M. Irizarry
• John V Irwin, RRT
• Allison Ivey
• Treless Ivey
• Osayande Stephen Izeiyamu, MD

• Primary Care Clinic/Center in Lake City, FL
• Providers in Lake City, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; 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.