| Lake City Regional Medical Group Llc | |
|
4225 Nw American Ln Lake City FL 32055-8841 | |
| (386) 758-6141 | |
| (386) 758-6140 |
| Full Name | Lake City Regional Medical Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 4225 Nw American Ln, Lake City, Florida |
| Authorized Official Name and Position | John Mark Rodkey (VICE PRESIDENT) |
| Authorized Official Contact | 8505233816 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake City Regional Medical Group Llc 2000 Health Park Dr Brentwood TN 37027-4525 Ph: (615) 372-5426 | Lake City Regional Medical Group Llc 4225 Nw American Ln Lake City FL 32055-8841 Ph: (386) 758-6141 |
| NPI Number | 1184910036 |
|---|---|
| Provider Enumeration Date | 06/20/2011 |
| Last Update Date | 11/10/2017 |
| Medicare PECOS PAC ID | 5294908901 |
|---|---|
| Medicare Enrollment ID | O20111025000347 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184910036 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Ernest P De Leon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558454603 PECOS PAC ID: 1254525413 Enrollment ID: I20101102000300 |
| Provider Name | Camilla D Pace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740747047 PECOS PAC ID: 1557602984 Enrollment ID: I20190411000735 |
| Provider Name | Caroline Witt Nettles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518584606 PECOS PAC ID: 1557789088 Enrollment ID: I20200916000875 |
| Provider Name | Valerie Katiana Vazquez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013450477 PECOS PAC ID: 8527421312 Enrollment ID: I20230827000076 |
| Provider Name | Yi Wang |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417290248 PECOS PAC ID: 3072742865 Enrollment ID: I20230912002411 |
Ernest De Leon, Md, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4225 Nw American Ln, Lake City, FL 32055 Phone: 386-758-6141 | |
Richard Weizenecker, M.d., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1297 Sw State Road 47, Lake City, FL 32025 Phone: 386-752-4711 Fax: 386-752-5075 | |
Palms Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 173 Nw Albritton Ln, Lake City, FL 32055 Phone: 386-755-4020 Fax: 386-752-9143 | |
Internal Medicine Of Lake City , Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 334 Sw Commerce Dr, Suite 2, Lake City, FL 32025 Phone: 386-755-1703 Fax: 386-755-1744 | |
Randolph Medical Practices Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1847 Sw Barnett Way, Lake City, FL 32025 Phone: 386-755-1440 Fax: 386-758-5628 | |
Raimah Primary Care Center Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1283 Sw State Road 47, 103, Lake City, FL 32025 Phone: 386-754-0339 Fax: 386-754-0393 | |
Cassidy Health And Wellness Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 310 S Marion Ave, Lake City, FL 32025 Phone: 386-438-5722 Fax: 386-438-8631 |