Lake Shore Center for Aesthetics & Plastic Surgery PA

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

ME 105501 Issued in FL

Legal business name

LAKE SHORE CENTER FOR AESTHETICS & PLASTIC SURGERY PA

Practice address

263 SW Professional GLN
Lake City, FL 32025-1105

Phone

(386) 755-6676

Fax

(386) 755-1667

NPI assigned

Nov 4, 2013

Last updated

Jan 7, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Melinda Keener, MDNPI 1861615098

Title

President

Phone

(386) 755-6676

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Melinda G Keener, MD

  • Plastic Surgery Physician
  • Lake City, FL
  • NPI 1861615098
  Authorized official Same address or phone

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389052800000",
    "number": "1477982171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 SW PROFESSIONAL GLN",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320251105",
            "telephone_number": "386-755-6676",
            "fax_number": "386-755-1667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 SW PROFESSIONAL GLN",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320251105",
            "telephone_number": "386-755-6676",
            "fax_number": "386-755-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE SHORE CENTER FOR AESTHETICS & PLASTIC SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-04",
        "last_updated": "2014-01-07",
        "status": "A",
        "authorized_official_last_name": "KEENER",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-755-6676",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME 105501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake City Spine & Injury, LLC
• Lake City Surgery Center, LLC
• Lake City Veteran's Hospital
• Lake City Vision PA
• Lake Citytherapeutic LLC
• Lake Shore Hma Medical Group LLC
• Lake Shore Hma, LLC (Shands Lake Shore Regional Medical Center)
• Lake Shore Hma, LLC (Shands Lake Shore Regional Medical Center)
• Vasu Nagaraju Lakkimsetti, M.D.,
• Anthony R Lambert, PA-C

• Plastic Surgery Physician in Lake City, FL
• Providers in Lake City, FL by specialty
• Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2014; 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.