Lake Center of H.O.P.E., PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

75000006578 Issued in FL

Legal business name

LAKE CENTER OF H.O.P.E., PA

Practice address

33057 Professional Drive
Suite 102
Leesburg, FL 34788

Phone

(352) 787-0081

Fax

(352) 314-9444

NPI assigned

Jun 15, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Lourdes Nicolas Ungson, OFFICE MANAGER

Title

Secretary Treasurer

Phone

(352) 787-0081

Specialties & licenses 1

Addresses

Other names 1

• Nick M Ungson, .M.D., PA Other name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 5

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

• James Marvin Moore Jr., ED.D.

  • Clinical Psychologist
  • The Villages, FL
  • NPI 1134116544
  Medicare reassignment NPD
• Nick Maron Ungson, M.D.

  • Psychiatry Physician
  • Leesburg, FL
  • NPI 1750431433
  Medicare reassignment NPD
• Susan Jane Bingel, LCSW

  • Clinical Social Worker
  • Leesburg, FL
  • NPI 1790002103
  NPD (past)
• Karen E Courchaine, PH.D.

  • Psychologist
  • Lake City, FL
  • NPI 1982630265
  NPD (past)
• Carolyn Mae Dower, LCSW

  • Clinical Social Worker
  • Leesburg, FL
  • NPI 1083972780
  NPD (past)

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382313600000",
    "number": "1366647802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33057 PROFESSIONAL DRIVE",
            "address_2": "SUITE 102",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347887507",
            "telephone_number": "352-787-0081",
            "fax_number": "352-314-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33057 PROFESSIONAL DRIVE",
            "address_2": "SUITE 102",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "34788",
            "telephone_number": "352-787-0081",
            "fax_number": "352-314-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CENTER OF H.O.P.E., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-15",
        "last_updated": "2013-10-21",
        "status": "A",
        "authorized_official_last_name": "UNGSON",
        "authorized_official_first_name": "LOURDES",
        "authorized_official_middle_name": "NICOLAS",
        "authorized_official_title_or_position": "SECRETARY TREASURER",
        "authorized_official_telephone_number": "352-787-0081",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OFFICE MANAGER"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "75000006578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nick M Ungson, .M.D., PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Omar Lababidi, DMD
• Jeanne Ruelo Labasbas, P.T.
• Lake Arthritis Center P a
• Lake Cancer & Hematology PA
• Lake Cancer Medical Center PA
• Lake Centre Home Care LLC
• Lake Centre Home Care, LLC
• Lake County Anesthesia Associates PA
• Lake County Neurology, PA
• Lake County Neurosurgicaland Spinal Institute

• Specialist in Leesburg, FL
• Providers in Leesburg, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2013; 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.