Lake Nona Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LAKE NONA SURGERY CENTER, LLC

Practice address

6424 Alexandra Louise Dr Ste 400
Orlando, FL 32827-5810

Phone

(407) 610-6648

Fax

(855) 719-2579

NPI assigned

Nov 12, 2025

Organization subpart

No

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

Authorized official

Name

Mr. Rey Estevan

Title

MGR

Phone

(352) 622-4251

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1762905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765843200000",
    "number": "1396605507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6424 ALEXANDRA LOUISE DR STE 400",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328275810",
            "telephone_number": "407-610-6648",
            "fax_number": "855-719-2579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6424 ALEXANDRA LOUISE DR STE 400",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328275810",
            "telephone_number": "407-610-6648",
            "fax_number": "855-719-2579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE NONA SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-12",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A",
        "authorized_official_last_name": "ESTEVAN",
        "authorized_official_first_name": "REY",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "352-622-4251",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PH35954",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lake Nona Medical Services
• Lake Nona Ophthalmology PL
• Lake Nona Psychiatric Associates, LLC
• Lake Nona Psychiatric Center, PA
• Lake Nona Spine Center, Inc.
• Lake Nona Vision Inc
• Joleen Marie Lake, A.P.R.N.
• Leah Lake, CERTIFIED NURSE ASSI
• Lakefront Medical Center PA
• Lakesha N. Richards

• Ambulatory Surgical Clinic/Center in Orlando, FL
• Providers in Orlando, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.