Infectious Disease of Lake County,LLC

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

Organization subpart

No

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

Authorized official

Name

Yulisa Astudillo, APRN

Title

Manager

Phone

(352) 835-2391

Specialties & licenses 1

Addresses

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": []
}

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• Multi-Specialty Clinic/Center in Tavares, FL
• Providers in Tavares, FL by specialty
• Multi-Specialty Clinic/Center in Florida

• 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.