Lakeside Neurology and Radiology

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

LAKESIDE NEUROLOGY AND RADIOLOGY

Practice address

12673 S Dixie Hwy
Miami, FL 33156-5958

Phone

(800) 416-1767

Fax

(888) 317-4206

NPI assigned

May 20, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Thomas Winger

Title

Business Manager

Phone

(800) 416-1767

Specialties & licenses 1

Addresses

Other names 1

• Lakeside Neurology Other name

Locations

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

{
    "created_epoch": "1274313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274313600000",
    "number": "1477872125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2516 WAUKEGAN RD",
            "address_2": "STE 386",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600251774",
            "telephone_number": "800-416-1767",
            "fax_number": "888-317-4206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12673 S DIXIE HWY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331565958",
            "telephone_number": "800-416-1767",
            "fax_number": "888-317-4206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE NEUROLOGY AND RADIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-20",
        "last_updated": "2010-05-20",
        "status": "A",
        "authorized_official_last_name": "WINGER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "800-416-1767",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Neurology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Gaspar Dixan Lake Perez
• Michael Thomas Lake, M.D.
• Norma Salenah Lake, MD
• Rose Mary Lake
• Lakes Psychiatry LLC
• Lakeview Alf, Corp.
• Lakeview Community Centers Inc
• Lakeview Senior Care Inc
• Shaheen Emmanuel Lakhan, MD, PHD, FAAN
• Khalid Lakhdar-Azzouz

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.