| Lakeside Family Medical Center | |
|
1939 Highland Oaks Blvd Lutz FL 33559-7323 | |
| (813) 948-1234 | |
| (813) 949-8408 |
| Full Name | Lakeside Family Medical Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 1939 Highland Oaks Blvd, Lutz, Florida |
| Authorized Official Name and Position | Jerambhai T Kankotia (DOCTOR) |
| Authorized Official Contact | 8139481234 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Family Medical Center 1939 Highland Oaks Blvd Lutz FL 33559-7323 Ph: (813) 948-1234 | Lakeside Family Medical Center 1939 Highland Oaks Blvd Lutz FL 33559-7323 Ph: (813) 948-1234 |
| NPI Number | 1235191362 |
|---|---|
| Provider Enumeration Date | 04/04/2006 |
| Last Update Date | 08/26/2011 |
| Medicare PECOS PAC ID | 9638351786 |
|---|---|
| Medicare Enrollment ID | O20110310000210 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235191362 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jerambhai T Kankotia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437231065 PECOS PAC ID: 7214119072 Enrollment ID: I20110315000868 |
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