Nephrology Associates of Lake County LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

NEPHROLOGY ASSOCIATES OF LAKE COUNTY LLC

Practice address

3801 N Highway 19a
Suite 400
Mount Dora, FL 32757-2228

Phone

(352) 383-1245

Fax

(352) 383-4401

NPI assigned

Feb 11, 2011

Last updated

Feb 11, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Suzanne Lynn Staves

Title

Office Manager

Phone

(352) 383-1245

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1297382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297382400000",
    "number": "1316244296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 N HIGHWAY 19A",
            "address_2": "SUITE 400",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327572228",
            "telephone_number": "352-383-1245",
            "fax_number": "352-383-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 N HIGHWAY 19A",
            "address_2": "SUITE 400",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327572228",
            "telephone_number": "352-383-1245",
            "fax_number": "352-383-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHROLOGY ASSOCIATES OF LAKE COUNTY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-11",
        "last_updated": "2011-02-11",
        "status": "A",
        "authorized_official_last_name": "STAVES",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "352-383-1245"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nephrology Physician in Mount Dora, FL
• Providers in Mount Dora, FL by specialty
• Nephrology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2011; 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.