| Lake Behavioral Health Management | |
|
225 W Canton Ave Ste 600 Winter Park FL 32789-3181 | |
| (407) 622-8086 | |
| Not Available |
| Full Name | Lake Behavioral Health Management |
|---|---|
| Speciality | Psychiatry & Neurology - Geriatric Psychiatry |
| Location | 225 W Canton Ave Ste 600, Winter Park, Florida |
| Authorized Official Name and Position | David Corddry (OWNER) |
| Authorized Official Contact | 4076228086 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Behavioral Health Management 225 W Canton Ave Ste 600 Winter Park FL 32789-3181 Ph: (407) 622-8086 | Lake Behavioral Health Management 225 W Canton Ave Ste 600 Winter Park FL 32789-3181 Ph: (407) 622-8086 |
| NPI Number | 1356811897 |
|---|---|
| Provider Enumeration Date | 11/27/2018 |
| Last Update Date | 11/27/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356811897 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Secondary |
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | (* (Not Available)) | Primary |
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