| Lake Pediatrics, P.A. | |
|
4880 N Highway 19a Ste 200 Mount Dora FL 32757-2018 | |
| (352) 589-8111 | |
| (352) 589-8111 |
| Full Name | Lake Pediatrics, P.A. |
|---|---|
| Speciality | Clinic/Center |
| Location | 4880 N Highway 19a Ste 200, Mount 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 Highway 19a Ste 200 Mount Dora FL 32757-2018 Ph: (352) 589-8111 |
| NPI Number | 1942367370 |
|---|---|
| Provider Enumeration Date | 01/03/2007 |
| Last Update Date | 11/12/2025 |
| Certification Date | 11/12/2025 |
| Medicare PECOS PAC ID | 1557326709 |
|---|---|
| Medicare Enrollment ID | O20041130000052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942367370 | NPI | - | NPPES |
| 126977000 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
| 208000000X | Pediatrics | () | Secondary |
Jerry M Alstott MD Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8030 Saint James Way, Mount Dora, FL 32757 Phone: 407-908-0064 Fax: 352-383-9319 |
Mount Dora Family Practice PA Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18540 Us Highway 441, Mount Dora, FL 32757 Phone: 352-383-7743 Fax: 352-383-9226 |
Breakthrough Transitions LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2110 N Donnelly St Ste 500, Mount Dora, FL 32757 Phone: 321-362-4176 Fax: 321-256-5176 |
Kathryn Johnson Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4400 N Highway 19a, Suite 4, Mount Dora, FL 32757 Phone: 352-988-4181 |
Daybreak Pediatric Housecalls, P.A. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 925 Northside Dr, Mount Dora, FL 32757 Phone: 352-359-2757 Fax: 866-215-0354 |
Chinyere Center for Wellness, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 131 E 19th Ave, Mount Dora, FL 32757 Phone: 352-735-3396 |