Lakeside Surgery LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LAKESIDE SURGERY LLC

Doing business as

Lakeside Surgery Center

Practice address

1825 N Mills Ave
Orlando, FL 32803

Phone

(407) 206-2375

Fax

(407) 206-2377

NPI assigned

May 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. John Lehr

Title

President

Phone

(078) 938-2004

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Lakeside Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

Lakeside Surgery LTDCCN 10C0001284

Medicare certification status

ActiveFrom the Provider of Services file

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645401600000",
    "number": "1477507168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 N MILLS AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32803",
            "telephone_number": "407-206-2375",
            "fax_number": "407-206-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 N MILLS AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32803",
            "telephone_number": "407-206-2375",
            "fax_number": "407-206-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A",
        "authorized_official_last_name": "LEHR",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "078-938-2004",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "306",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "490003489",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "638",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079231400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lakeside Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lakesha N. Richards
• Lakeside Med Supplies
• Lakeside Occupational Medical Centers, Inc.
• Lakeside Occupational Medical Centers, Inc.
• Lakeside of Orlando Inc
• Lakeside Surgery LTD
• Lakeview Manor Assisted Living Facility
• Lakeview Manor Assisted Living Facility, Inc.
• Lakeview Surgery Center, LLC
• Cristian Morgan Lallo

• 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 Feb 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.