| Lakeside Family Medicine, P.a. | |
|
4685 N Highway 19a Mount Dora FL 32757-2039 | |
| (352) 589-5900 | |
| (352) 589-5904 |
| Full Name | Lakeside Family Medicine, P.a. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 4685 N Highway 19a, Mount Dora, Florida |
| Authorized Official Name and Position | Gerald Edward Reynolds (PRESIDENT OF LAKESIDE FAMILY MEDICI) |
| Authorized Official Contact | 3525895900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Family Medicine, P.a. 4685 N Highway 19a Mount Dora FL 32757-2039 Ph: (352) 589-5900 | Lakeside Family Medicine, P.a. 4685 N Highway 19a Mount Dora FL 32757-2039 Ph: (352) 589-5900 |
| NPI Number | 1679732689 |
|---|---|
| Provider Enumeration Date | 06/04/2008 |
| Last Update Date | 03/25/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679732689 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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