Lakeside Medical LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LAKESIDE MEDICAL LLC

Practice address

600 N Hiatus Rd Ste 203
Pembroke Pines, FL 33026-5207

Phone

(954) 392-7157

Fax

(954) 443-4941

NPI assigned

Aug 10, 2018

Organization subpart

No

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

Authorized official

Name

Armando De FeriaNPI 1639179807

Title

President

Phone

(954) 392-7157

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Armando A De Feria, M.D.

  • Internal Medicine Physician
  • Pembroke Pines, FL
  • NPI 1639179807
  Medicare reassignment Care Compare group NPD Authorized official
• Lisset Gonzalez Perez, APRN, MSN, FNP,, BC

  • Family Nurse Practitioner
  • Miami, FL
  • NPI 1659953610
  Medicare reassignment Care Compare group NPD
• Jennifer Nieves-Cunningham, ARNP

  • Family Nurse Practitioner
  • Pembroke Pines, FL
  • NPI 1700825601
  Medicare reassignment NPD
• Megan Elizabeth Janson, M.D.

  • Family Medicine Physician
  • Wolfforth, TX
  • NPI 1366738478

  FL

  Medicare reassignment NPD
• Chelsey Perez

  • Physician Assistant
  • West Palm Beach, FL
  • NPI 1053042333
  Medicare reassignment
• Tyesha Bowen, AGNP

  • Adult Health Nurse Practitioner
  • West Palm Beach, FL
  • NPI 1629440516
  NPD

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

{
    "created_epoch": "1533859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533859200000",
    "number": "1356820286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N HIATUS RD STE 203",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330265207",
            "telephone_number": "954-392-7157",
            "fax_number": "954-443-4941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N HIATUS RD STE 203",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330265207",
            "telephone_number": "954-392-7157",
            "fax_number": "954-443-4941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-10",
        "last_updated": "2018-08-10",
        "status": "A",
        "authorized_official_last_name": "DE FERIA",
        "authorized_official_first_name": "ARMANDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-392-7157"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lidie Lajoie, M.D.
• Lakes Mall Dental
• Lakes Mall Dental Center , PA
• Lakeside Med LLC
• Lakeside Medical and Aesthetic Centre LC
• Habeeb Ali Lakhani, M.D.
• Lakou Medical Consulting LLC
• Karim Lalani, APRN
• Daniela Lalinde, DDS
• Vinod Lall

• Internal Medicine Physician in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2018; 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.