Lakeland Surgical & Diagnostic Center LLP
Organization Active NPI Ambulatory Surgical Clinic/Center · Lakeland, FL
NPI 1962552232 · NPPES record last updated Mar 18, 2016
Key facts
- NPI
- 1962552232
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- License
- 1213 (FL)
- Legal business name
- LAKELAND SURGICAL & DIAGNOSTIC CENTER LLP
- Practice address
- 818 Griffin Rd
Lakeland, FL 33805-2440 - Phone
- (863) 687-0566
- Fax
- (863) 616-9289
- NPI assigned
- Jan 11, 2007
- Organization subpart
- No
Authorized official
- Name
- Ms. Emily Duncan
- Title
- Ceo
- Phone
- (863) 683-2428
Member of 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100708000812 | FL | Part B Supplier - Ambulatory Surgical Center | 3072507607 | Practice locations: Lakeland, FL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | 1213 | FL | Yes |
Addresses
Primary practice location
818 Griffin Rd
Lakeland, FL 33805-2440
Mailing address
115 S Missouri Ave
Ste 101
Lakeland, FL 33815-4600
Phone (863) 683-2428
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 014447700 | Medicaid | FL | |
| 6H3 | Other | FL | BCBS |
| 10111447AC17 | Other | FL | BEECHSTREET CDPHP |
| 490003123 | Other | FL | RR MEDICARE |
Other names
- GRIFFIN RD CAMPUS OF LSDC
Other providers in Lakeland, FL
- Lakeland Regional Health Systems, Inc.
- Lakeland Regional Medical Center, Inc.
- Lakeland SNF Investors LLC
- Lakeland SNF Operations LLC
- Lakeland Sports Performance Inc
- Lakeland Therapy Providers, Inc
- Lakeland Therapy Providers, Inc.
- Lakeland Urology PA
- Lakeland Volunteers in Medicine
- Lakeland Volunteers in Medicine
All providers in Lakeland, FL · Ambulatory Surgical Clinic/Center in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.