Lakewood CCL, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

LAKEWOOD CCL, LLC

Practice address

5571 E Sr 44 Ste 501
Wildwood, FL 34785-8282

Phone

(352) 643-9070

Fax

(352) 571-6787

NPI assigned

Oct 29, 2018

Last updated

Oct 29, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jose A Rivera

Title

Administrator

Phone

(352) 643-9070

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 13

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.

• Rafik Abadier, M.D.

  • Cardiovascular Disease Physician
  • Inverness, FL
  • NPI 1649253147
  NPD
• Nitza I Alvarez Torres, M.D.

  • Cardiovascular Disease Physician
  • Lady Lake, FL
  • NPI 1659491983
  NPD
• Srinivas Attanti, MD

  • Interventional Cardiology Physician
  • The Villages, FL
  • NPI 1902889413
  NPD
• Georg Josef Couturier, MD

  • Cardiovascular Disease Physician
  • The Villages, FL
  • NPI 1710952486
  NPD
• Hector L Garcia, M.D.

  • Interventional Cardiology Physician
  • The Villages, FL
  • NPI 1114910031
  NPD
• Javier M Gonzalez, MD

  • Cardiovascular Disease Physician
  • The Villages, FL
  • NPI 1689658809
  NPD
• Hari CP Kannam, MD

  • Interventional Cardiology Physician
  • Inverness, FL
  • NPI 1952542375
  NPD
• Vinod R Miryala, MD

  • Cardiovascular Disease Physician
  • The Villages, FL
  • NPI 1891996880
  NPD
• Nishant K. Nerella, MD

  • Cardiovascular Disease Physician
  • Inverness, FL
  • NPI 1467659599
  NPD
• Suman Pasupuleti, M.D,

  • Clinical Cardiac Electrophysiology Physician
  • Inverness, FL
  • NPI 1851503809
  NPD
• Abel Rivero, M.D.

  • Interventional Cardiology Physician
  • The Villages, FL
  • NPI 1659531937
  NPD
• Brian Harris Saluck, DO

  • Interventional Cardiology Physician
  • The Villages, FL
  • NPI 1295796902
  NPD

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540771200000",
    "number": "1922575802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5571 E SR 44 STE 501",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347858282",
            "telephone_number": "352-643-9070",
            "fax_number": "352-571-6787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5571 E SR 44 STE 501",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347858282",
            "telephone_number": "352-643-9070",
            "fax_number": "352-571-6787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD CCL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-29",
        "last_updated": "2018-10-29",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "352-643-9070",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Kitos, APRN FNP-BC
• Kuhn Chiropractic PA
• David C Kuhn, DC
• La Plus Family Investment (Active Therapy)
• Lakewood ASC, LLC
• Maria Jarosch Largent, M.S., CCC-A
• Tasha Lasane
• Jowatha Maner Lee
• Leonidas Vitality Health Clinic
• Levante Medical LLC

• Multi-Specialty Clinic/Center in Wildwood, FL
• Providers in Wildwood, 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 Oct 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.