Lake City Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

1046 Issued in FL

Legal business name

LAKE CITY SURGERY CENTER, LLC

Practice address

208 SW Prosperity Place
Lake City, FL 32024

Phone

(386) 487-3930

Fax

(386) 487-3935

NPI assigned

Jul 18, 2007

Organization subpart

No

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

Authorized official

Name

Collin Lemaistre

Title

Officer/Authorized Official

Phone

(214) 213-0732

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

Lake City Surgery Center LLCCCN 10C0001276

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Lake City Outpatient Anesthesia PLLC

  • Anesthesiology Physician
  • Lake City, FL
  • NPI 1316171010

  Member Of

  NPD member

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753833600000",
    "number": "1598965634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 SW PROSPERITY PLACE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "32024",
            "telephone_number": "386-487-3930",
            "fax_number": "386-487-3935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 SW PROSPERITY PLACE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "32024",
            "telephone_number": "386-487-3930",
            "fax_number": "386-487-3935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CITY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A",
        "authorized_official_last_name": "LEMAISTRE",
        "authorized_official_first_name": "COLLIN",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "214-213-0732"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "1046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASC MEDICARE IDENTIFICATI",
            "identifier": "10-C0001276",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lake City Outpatient Anesthesia PLLC
• Lake City Pharmacy Inc
• Lake City Regional Medical Group LLC
• Lake City Rehab LLC
• Lake City Spine & Injury, LLC
• Lake City Veteran'S Hospital
• Lake City Vision PA
• Lake Citytherapeutic LLC
• Lake Shore Center for Aesthetics & Plastic Surgery PA
• Lake Shore Hma Medical Group LLC

• Ambulatory Surgical Clinic/Center in Lake City, FL
• Providers in Lake City, 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 Jul 30, 2025; 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.