Elite Medical Services at Lakeside LLC
Organization Active NPI Emergency Medicine Physician · Belle Glade, FL
NPI 1992216568 · NPPES record last updated Dec 12, 2017
Key facts
- NPI
- 1992216568
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- ELITE MEDICAL SERVICES AT LAKESIDE LLC
- Practice address
- Lakeside Medical Center Emergency Department
39200 Hooker Hwy
Belle Glade, FL 33430-5368 - Phone
- (561) 996-6571
- NPI assigned
- Oct 23, 2017
- Organization subpart
- No
Authorized official
- Name
- Kenneth A Scheppke, MD
- Title
- President
- Phone
- (561) 436-2291
Practitioners 48
-
David Bohorquez, DO
-
Amber Hughes, ARNP
-
Daniel Padron, D.O.
-
Richard Powell Jr., M.D.
-
Mechele Lee Smith, ARNP
-
Damaris Vargas, D.O.
-
Daniel Aronovich, D.O.
-
Patrick Edward Davison, D.O.
-
Tina M Dochniak, DNP, ARNP
-
Christopher Downey, M.D
-
Catherine Feliciano, D.O.
-
Richard Giroux, D.O.
-
Daniel Aaron Grenier, D.O.
-
Roxanne Patricia Imam Obikwu, MSN, APRN, FNP - BC
-
Sophia Padron, APRN
-
Jin Yu Paredes, DO
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180406001651 | FL | Part B Supplier - Clinic/Group Practice | 8921361882 |
Receives reassigned benefits from 48 practitioners Practice locations: Belle Glade, FL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes |
Addresses
Primary practice location
Lakeside Medical Center Emergency Department
39200 Hooker Hwy
Belle Glade, FL 33430-5368
Mailing address
PO Box 12010
Daytona Beach, FL 32120-2010
Phone (386) 274-7800
Other providers in Belle Glade, FL
- Audrey G. Dorsett
- Chaniya Dowers
- Ehs at Lakeside LLC
- Ahmed El Guindi
- El Roble Assisted Living Facility Inc
- Empowering Healthcare, LLC
- Kedner Etienne
- Monique Ettenne
- Evernorth Direct Health LLC
- Excellent Ultimate Medical Center, PLLC
All providers in Belle Glade, FL · Emergency Medicine Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2017. 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.