Lake County Primary Medical Care LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LAKE COUNTY PRIMARY MEDICAL CARE LLC

Practice address

33 N Center St
Suite a
Eustis, FL 32726-3580

Phone

(352) 357-0880

Fax

(352) 357-0334

NPI assigned

Oct 19, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Sujatha Baskar, MDNPI 1699764910

Title

Owner

Phone

(352) 357-0880

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Sujatha Baskar, MD

  • Internal Medicine Physician
  • Tavares, FL
  • NPI 1699764910
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356912000000",
    "number": "1568451888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 N CENTER ST",
            "address_2": "SUITE A",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327263580",
            "telephone_number": "352-357-0880",
            "fax_number": "352-357-0334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 N CENTER ST",
            "address_2": "SUITE A",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327263580",
            "telephone_number": "352-357-0880",
            "fax_number": "352-357-0334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE COUNTY PRIMARY MEDICAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-19",
        "last_updated": "2012-12-31",
        "status": "A",
        "authorized_official_last_name": "BASKAR",
        "authorized_official_first_name": "SUJATHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-357-0880",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274014100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paige Nicole Kwasigroch, CCC-SLP
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• Christina Victoria Tokics Lacek, PT, DPT
• Tanya Jean Lafrinere
• Marie Laguerre Small, SLPA
• Lake County Spine and Injury
• Lake Eustis Operating Investments LLC (Bedrock Rehabilitation and Nursing Center at Lake Eustis)
• Lake Foot Clinic Inc
• Lake Health Care Center Inc
• Lake Internal Medicine Associates

• Internal Medicine Physician in Eustis, FL
• Providers in Eustis, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2012; 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.