Active NPI
Mikhailia Wanakee Lake, MD
- Cardiovascular Disease Physician
- Fort Lauderdale, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- ME 112403
- Practice address
- 1625 SE 3Rd Ave Ste 620
Fort Lauderdale, FL 33316-2521 - Phone
- (954) 320-3380
- Fax
- (954) 320-3371
- NPI assigned
- Apr 28, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | ME 112403 | FL | Primary |
Addresses
Primary practice location
1625 SE 3Rd Ave Ste 620
Fort Lauderdale, FL 33316-2521
Mailing address
1608 SE 3Rd Ave FL 3
Fort Lauderdale, FL 33316-2564
Phone (954) 320-3380
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 119118000 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, GA, MT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Emory University School of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 W Sample Rd
Deerfield Beach, FL 33064-3547
1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510
1625 SE 3 Ave
Fort Lauderdale, FL 33316-2521
1625 SE 3Rd Ave
Suite 525
Ft Lauderdale, FL 33316-2521
Phone (954) 355-4975
201 E Sample Rd
Deerfield Beach, FL 33064-3502
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 112403 | FL | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Broward Hospital District | Current | Accepting new patients | |
| Holy Cross Hospital, Inc | Current | Accepting new patients | |
| Lee Health System Inc | Current | Accepting new patients | |
| Lee Memorial Health System | Current | Accepting new patients | |
| Lee Health System Inc | Current | Accepting new patients | |
| Holy Cross Primary Care, Inc | Current | Accepting new patients | |
| Prairie County Hospital District | Current | Accepting new patients | |
| North Broward Hospital District | Current | Accepting new patients | |
| Holy Cross Hospital Inc | Cardiovascular Disease | Current | Accepting new patients |
| North Broward Hospital District | Cardiovascular Disease | Current | Accepting new patients |
| McCone County Health Center, Inc. | Past | Accepting new patients |
Locations
1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900
708 Del Prado Blvd S
Ste 7
Cape Coral, FL 33990
Phone (239) 424-3660
636 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 332-5344
1 W Sample Rd
Ste 208
Deerfield Beach, FL 33064
Phone (954) 946-2570
13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000
8960 Colonial Center Dr
Ste 302
Fort Myers, FL 33905
Phone (239) 343-9633
9981 S Healthpark Dr
Fort Myers, FL 33908
Phone (239) 332-5344
8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030
13340 Metro Pkwy
Ste 200
Fort Myers, FL 33966
Phone (239) 343-0550
1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700
2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000
4725 N Federal Hwy
#401
Ft Lauderdale, FL 33308
Phone (954) 772-2136
1608 SE 3rd Ave
Fl 3
Ft Lauderdale, FL 33316
1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000
1625 SE 3rd Ave
Ste 620
Ft Lauderdale, FL 33316
Phone (954) 320-3380
1309 S Federal Hwy
#G
Ft Lauderdale, FL 33316
Phone (954) 463-4383
930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520
1000 NE 56th St
Oakland Park, FL 33334
Phone (954) 229-8608
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Interoperability endpoints
- mlake86685@direct.leememorial.org
- mlake2023536@direct.trinity-health.org
Organizations & group practices 13
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba BH Physicians North
- Neurological Surgery Physician
- Fort Lauderdale, FL
- NPI 1801581129
-
dba Holy Cross Medical Group
- Internal Medicine Physician
- Ft. Lauderdale, FL
- NPI 1467401877
Cardiovascular Disease
-
- Family Medicine Physician
- Coral Springs, FL
- NPI 1740637735
-
- Internal Medicine Physician
- Fort Myers, FL
- NPI 1942058557
-
dba Prairie Community Hospital
- Critical Access Hospital
- Terry, MT
- NPI 1760489272
-
- Internal Medicine Physician
- Fort Myers, FL
- NPI 1992873319
-
dba Piedmont Heart Institute
- Cardiovascular Disease Physician
- Atlanta, GA
- NPI 1275729691
-
dba Holy Cross Diabetes Prevention Program
- Health & Wellness Coach
- Oakland Park, FL
- NPI 1063207595
-
dba Lee Health Specialty Pharmacy
- Community/Retail Pharmacy
- Bonita Springs, FL
- NPI 1699510925
-
dba LCH- Pediatric Ophthalmology
- Federally Qualified Health Center (FQHC)
- Fort Myers, FL
- NPI 1770165920
-
dba Broward Health Annie L. Weaver Health Center Pharmacy
- Community/Retail Pharmacy
- Pompano Beach, FL
- NPI 1699709766
-
dba BH Physicians Main
- Cardiovascular Disease Physician
- Fort Lauderdale, FL
- NPI 1811508005
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Broward Health Medical Center
- General Acute Care Hospital
- Fort Lauderdale, FL
- NPI 1285662239
-
dba Broward Health Lighthouse Point ER
- General Acute Care Hospital
- Pompano Beach, FL
- NPI 1376571323
-
dba Broward Health North
- Emergency Care Clinic/Center
- Lighthouse Point, FL
- NPI 1720936792
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753747200000",
"number": "1639344914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1608 SE 3RD AVE FL 3",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333162564",
"telephone_number": "954-320-3380",
"fax_number": "954-320-3371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1625 SE 3RD AVE STE 620",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333162521",
"telephone_number": "954-320-3380",
"fax_number": "954-320-3371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAKE",
"first_name": "MIKHAILIA",
"middle_name": "WANAKEE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-28",
"last_updated": "2025-07-29",
"certification_date": "2025-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "FL",
"license": "ME 112403",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "119118000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.