Lake'S Medical Office

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

HCC4716 Issued in FL

Legal business name

LAKE'S MEDICAL OFFICE

Practice address

6260 Johnson St
Hollywood, FL 33024-5932

Phone

(954) 961-8195

NPI assigned

Jul 19, 2007

Organization subpart

No

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

Authorized official

Name

Manuel C Acosta, OWNER

Title

President

Phone

(954) 961-8195

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184803200000",
    "number": "1295935013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6260 JOHNSON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330245932",
            "telephone_number": "954-961-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6260 JOHNSON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330245932",
            "telephone_number": "954-961-8195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE'S MEDICAL OFFICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-19",
        "last_updated": "2007-07-19",
        "status": "A",
        "authorized_official_last_name": "ACOSTA",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-961-8195",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "HCC4716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey Marie Lagmay, PA
• Heather Anne Laguardia, M.D.
• Freddy Laguerre, ARNP
• Simon Laine, ARNP
• Shelbie Lakatos
• Lakeview Alf Enterprises Inc
• Sara Lalani
• Olivia Lallouz
• Emmanesseau Lamarre, RRNA
• Ari Lamet, D.O.

• Health Service Clinic/Center in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Health Service Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; 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.