Lakeside Med Supplies

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

LAKESIDE MED SUPPLIES

Practice address

2415 Sand Lake Rd Ste G
Orlando, FL 32809-7701

Phone

(917) 436-2594

NPI assigned

Jan 9, 2023

Organization subpart

No

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

Authorized official

Name

Kadicha Williams

Title

President

Phone

(917) 436-2594

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673222400000",
    "number": "1700590296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 SAND LAKE RD STE G",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328097701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 SAND LAKE RD STE G",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328097701",
            "telephone_number": "917-436-2594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE MED SUPPLIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "KADICHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-436-2594"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Nona Vision Inc
• Joleen Marie Lake, A.P.R.N.
• Leah Lake, CERTIFIED NURSE ASSI
• Lakefront Medical Center PA
• Lakesha N. Richards
• Lakeside Occupational Medical Centers, Inc.
• Lakeside Occupational Medical Centers, Inc.
• Lakeside of Orlando Inc
• Lakeside Surgery LLC
• Lakeside Surgery LTD

• Durable Medical Equipment & Medical Supplies in Orlando, FL
• Providers in Orlando, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.