NPIMap

Organization Active NPI

Infectious Disease of Lake County,LLC

  • Multi-Specialty Clinic/Center
  • Tavares, FL
National Provider Identifier
1639636897
Registry record updated Feb 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
INFECTIOUS DISEASE OF LAKE COUNTY,LLC
Practice address
2050 Classique LN
Tavares, FL 32778-5787
Phone
(352) 835-2391
NPI assigned
Feb 25, 2019
Last updated
Feb 25, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2019

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

Authorized official

Name
Yulisa Astudillo, APRNNPI 1871003574
Title
Manager
Phone
(352) 835-2391

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

2050 Classique LN
Tavares, FL 32778-5787

Mailing address

2050 Classique LN
Tavares, FL 32778-5787

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551052800000",
    "number": "1639636897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 CLASSIQUE LN",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 CLASSIQUE LN",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785787",
            "telephone_number": "352-835-2391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFECTIOUS DISEASE OF LAKE COUNTY,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-25",
        "last_updated": "2019-02-25",
        "status": "A",
        "authorized_official_last_name": "ASTUDILLO",
        "authorized_official_first_name": "YULISA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "352-835-2391",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2019; 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.