Lake Mary Medical Services, LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

ME89809 Issued in FL

Legal business name

LAKE MARY MEDICAL SERVICES, LLC

Practice address

4300 W Lake Mary Blvd Ste 1010-378
Lake Mary, FL 32746-2060

Phone

(407) 415-5796

NPI assigned

Aug 2, 2017

Organization subpart

No

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

Authorized official

Name

Melanie K. Cross, MD

Title

Owner

Phone

(407) 415-5796

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553558400000",
    "number": "1699299537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 W LAKE MARY BLVD STE 1010-378",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462060",
            "telephone_number": "407-415-5796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 W LAKE MARY BLVD STE 1010-378",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462060",
            "telephone_number": "407-415-5796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE MARY MEDICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-02",
        "last_updated": "2019-03-26",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-415-5796",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME89809",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "FL",
            "license": "ME89809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "ME89809",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lake Mary Family Physicians P.a.
• Lake Mary Health Care Associates LLC
• Lake Mary Imaging Center, Inc.
• Lake Mary Infusion Center
• Lake Mary Medical Center
• Lake Mary Modern Dentistry, PA
• Lake Mary OB/GYN
• Lake Mary Plastic and Cosmetic Surgery PA
• Lake Mary Psychiatric Services LLC
• Lake Mary Psychiatry and Counseling LLC

• Pain Medicine (Anesthesiology) Physician in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Pain Medicine (Anesthesiology) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.