Organization Active NPI

Lakes Anesthesia LLC

  • Anesthesiology Physician
  • Hialeah, FL
National Provider Identifier
1356088512
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
LAKES ANESTHESIA LLC
Practice address
2100 W 76TH St Ste 101
Hialeah, FL 33016-5505
Phone
(305) 403-2560
Fax
(786) 439-2282
NPI assigned
May 18, 2022
Last updated
May 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Authorized official

Name
Mrs. Damarys Vega
Title
Owner
Phone
(305) 403-2560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

2100 W 76TH St Ste 101
Hialeah, FL 33016-5505

Mailing address

2100 W 76TH St Ste 101
Hialeah, FL 33016-5505
Phone (305) 403-2560

Other names 1

  • Lakes Anesthesia LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250116003307 FL Part B Supplier - Clinic/Group Practice 9133657299 Receives reassigned benefits from 3 practitioners
Practice locations: Hialeah, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652832000000",
    "number": "1356088512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 W 76TH ST STE 101",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330165505",
            "telephone_number": "305-403-2560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 W 76TH ST STE 101",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330165505",
            "telephone_number": "305-403-2560",
            "fax_number": "786-439-2282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKES ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-18",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A",
        "authorized_official_last_name": "VEGA",
        "authorized_official_first_name": "DAMARYS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-403-2560",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakes Anesthesia LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; 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.