Lakeside Med LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LAKESIDE MED LLC

Practice address

600 N Hiatus Rd Ste 203
Pembroke Pines, FL 33026-5207

Phone

(954) 392-7157

Fax

(954) 443-4941

NPI assigned

Dec 10, 2024

Organization subpart

No

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

Authorized official

Name

Armando Antenor De Feria, MDNPI 1639179807

Title

President

Phone

(954) 392-7157

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Armando A De Feria, M.D.

  • Internal Medicine Physician
  • Pembroke Pines, FL
  • NPI 1639179807
  Medicare reassignment NPD (past) Authorized official

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

{
    "created_epoch": "1733788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733788800000",
    "number": "1740096049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N HIATUS RD STE 203",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330265207",
            "telephone_number": "954-392-7157",
            "fax_number": "954-443-4941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N HIATUS RD STE 203",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330265207",
            "telephone_number": "954-392-7157",
            "fax_number": "954-443-4941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE MED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-10",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A",
        "authorized_official_last_name": "DE FERIA",
        "authorized_official_first_name": "ARMANDO",
        "authorized_official_middle_name": "ANTENOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-392-7157",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charmaine P Laing, MD
• Navid Lajevardi, DMD
• Lidie Lajoie, M.D.
• Lakes Mall Dental
• Lakes Mall Dental Center , PA
• Lakeside Medical and Aesthetic Centre LC
• Lakeside Medical LLC
• Habeeb Ali Lakhani, M.D.
• Lakou Medical Consulting LLC
• Karim Lalani, APRN

• Internal Medicine Physician in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.