| Lake Pediatrics P. A. | |
|
4880 N Hwy 19 A Mt Dora FL 32757-2018 | |
| (352) 589-8111 | |
| (352) 589-8111 |
| Full Name | Lake Pediatrics P. A. |
|---|---|
| Speciality | Pediatrics |
| Location | 4880 N Hwy 19 A, Mt Dora, Florida |
| Authorized Official Name and Position | Donna Lynn Nettles (BILLING MANAGER) |
| Authorized Official Contact | 5236384997 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Pediatrics P. A. 4880 N Hwy 19 A Mt Dora FL 32757-2018 Ph: (352) 589-8111 | Lake Pediatrics P. A. 4880 N Hwy 19 A Mt Dora FL 32757-2018 Ph: (352) 589-8111 |
| NPI Number | 1942367370 |
|---|---|
| Provider Enumeration Date | 01/03/2007 |
| Last Update Date | 01/11/2022 |
| Medicare PECOS PAC ID | 1557326709 |
|---|---|
| Medicare Enrollment ID | O20041130000052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942367370 | NPI | - | NPPES |
| 660103100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Primary |
Carehere Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Carehere Clinic- City Of Mount Dora, Fl, 2110 North Donnelly Street, Mt Dora, FL 32757 Phone: 615-221-5901 | |
Henry J Richter Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1502 N Donnelly St, Suite 110, Mt Dora, FL 32757 Phone: 352-735-0068 Fax: 352-735-0305 | |
Zisholtz Family Practice Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1502 N Donnelly Street, Suite 106, Mt Dora, FL 32757 Phone: 352-383-1324 |