Medical Associates of Lake Nona, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MEDICAL ASSOCIATES OF LAKE NONA, LLC

Practice address

2428 Clearlake Rd BLDG K
Cocoa, FL 32922-5722

Phone

(321) 795-6380

Fax

(321) 208-8717

NPI assigned

Feb 14, 2024

Organization subpart

No

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

Authorized official

Name

Stephen B Dodson, MDNPI 1215324512

Title

Owner

Phone

(321) 795-6380

Specialties & licenses 1

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, and the practitioner matching its NPPES authorized official.

• Stephen Dodson, M.D.

  • Hospitalist Physician
  • Melbourne, FL
  • NPI 1215324512

  Internal Medicine

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1707868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707868800000",
    "number": "1801651328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 560538",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329560538",
            "telephone_number": "321-795-6380",
            "fax_number": "321-208-8717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2428 CLEARLAKE RD BLDG K",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329225722",
            "telephone_number": "321-795-6380",
            "fax_number": "321-208-8717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES OF LAKE NONA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-14",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A",
        "authorized_official_last_name": "DODSON",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-795-6380",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arleen McEntee, LMHC
• Zachary McGuire
• Amanda Chau McKee
• Veronica Natalia McKnight, MSW
• Medfast Urgent Care Centers, LLC
• Medstaff
• Tejas Mehta
• Melodie's Place LLC
• Judith Mendiola, MA;CT;C-HCLC
• Hannuar Mendoza, RBT

• Internal Medicine Physician in Cocoa, FL
• Providers in Cocoa, 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 Feb 14, 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.