PLASTIC SURGERY CENTER OF LAKE COUNTY (NPI# 1073543310) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073543310 |
| Entity Type | Organization |
| Organization Name | PLASTIC SURGERY CENTER OF LAKE COUNTY |
| Other Organization Name | BOSSHARDT & MARZEK PLASTIC SURGERY ASSOCIATES |
| Practice Address |
1879 Nightingale Ln A-2 Tavares FL 32778-4363 |
| Practice Telephone | 3527420079 |
| Practice Fax Number | 3527420059 |
| Mailing Telephone | 3527420079 |
| Mailing Fax Number | 3527420059 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2008-06-18 |
| Authorized Official Name | MRS. VERA D. RENFRO (OFFICE ADMINISTRATOR) |
| Authorized Official Telephone | 3527420079 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
1049 | FL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RAILROAD MEDICARE | 490003374 | 01 |
| FL | 252761801 | 05 | |
| FL | BLUE CROSS AND SHIELD FL | 6B8 | 01 |
| Other Name | Type Code |
|---|---|
| Bosshardt & Marzek Plastic Surgery Associates | Doing Business As Name - Organization |
| Street Address |
1879 NIGHTINGALE LN A-2 |
| City | TAVARES |
| State | FL |
| Zip Code | 32778-4363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588661664 | Borys A Mascarenhas | Surgery | 1879 Nightingale Ln, Ste B4, Tavares, FL 32778-4363 | 2005-07-05 |
| 1285961219 | Andrea Campbell | Nurse Practitioner | 1879 Nightingale Ln, Suite C-1, Tavares, FL 32778-4363 | 2009-11-12 |
| 1225168701 | Keller & Goodman Md, Pa | Internal Medicine | 1879 Nightingale Ln, Suite C-2, Tavares, FL 32778-4363 | 2007-03-06 |
| 1376612358 | Theresa Ann Mills | Emergency Medicine | 1879 Nightingale Ln, Suite C-1, Tavares, FL 32778-4363 | 2006-11-06 |
| 1790881654 | Plastic Surgery Center of Lake County, P.a. | Plastic Surgery | 1879 Nightingale Ln, Suite #a-2, Tavares, FL 32778-4363 | 2006-09-16 |
| 1144330119 | Adina Mariana Ion | Internal Medicine | 1879 Nightingale Ln, Suite C-1, Tavares, FL 32778-4363 | 2006-08-30 |
| 1942235783 | Richard T Bosshardt | Plastic Surgery | 1879 Nightingale Ln, A-2, Tavares, FL 32778-4363 | 2006-07-11 |
| 1336171388 | Peter A. Marzek | Plastic Surgery | 1879 Nightingale Ln, A-2, Tavares, FL 32778-4363 | 2006-07-07 |
| 1821027517 | Julio Henry Lesmes | Internal Medicine | 1879 Nightingale Ln, Ste C-1, Tavares, FL 32778 | 2006-07-03 |
| 1467491993 | Open Mri of Orlando Inc | Clinic/Center | 1879 Nightingale Ln, Suite A-1, Tavares, FL 32778-4363 | 2006-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487173753 | Erica Denise Irvin | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4681 Marsh Harbor Dr, Tavares, FL 32778 | 2017-09-18 |
| 1922522499 | J&t Divine Care | Home Health | 1554 Auburn Hills Ct, Tavares, FL 32778 | 2017-07-27 |
| 1841738721 | Kelli Maragh | Behavior Technician | 12237 Tavares Ridge Circle, Tavares, FL 32778 | 2017-02-10 |
| 1831633692 | Amanda Williams Sellers | Nurse Practitioner | 1858 Mayo Dr, Tavares, FL 32778 | 2016-12-13 |
| 1235680042 | Natalie Roaine Ash-maheux | Occupational Therapist | 4501 Waterman Way, Tavares, FL 32778 | 2016-10-17 |
| 1396295713 | Sumiko Burley- Collins | Community Health Worker | 1572 Auburn Hills Court, Tavares, FL 32778 | 2016-10-10 |
| 1295100980 | Sunshine Therapy Group, Pa | Speech-Language Pathologist | 2050 Classique Lane, Tavares, FL 32778 | 2015-12-06 |
| 1093188385 | Jana Michelle England | Counselor | 1300 Duncan, Tavares, FL 32778 | 2015-11-09 |
| 1467865980 | Reshma Balmick | Hearing Instrument Specialist | 500 West Burleigh Blvd., Tavares, FL 32778 | 2014-06-03 |
| 1861825739 | Shelagh Kathryn Wood-gouveia | Nurse Practitioner | 1390 East Burleigh Blvd., Tavares, FL 32778 | 2013-08-15 |
| Find all providers in zip 32778 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558618116 | Tavares Surgery LLC | Clinic/Center | 1878 Mayo Dr, Tavares, FL 32778-4308 | 2012-08-13 |
| 1467783688 | Premier Surgical Center LLC | Clinic/Center | 2130 Vindale Rd., Tavares, FL 32778-5637 | 2010-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396351102 | University Medical Service Association Inc | Clinic/Center | 13330 Usf Laurel Dr Fl 2, Tampa, FL 33612-6601 | 2020-09-17 |
| 1437764321 | Baptist Health Surgery Center, LLC | Clinic/Center | 1228 S Pine Island Rd Ste 220, Plantation, FL 33324-4402 | 2020-09-09 |
| 1538773890 | Asc of Trinity | Clinic/Center | 15238 Virginia Station, Odessa, FL 33556 | 2020-09-03 |
| 1891309423 | Kingsley Endoscopy Center LLC | Clinic/Center | 970 Kingsley Avenue, Orange Park, FL 32073 | 2020-09-01 |
| 1780292359 | Gemini Ambulatory Surgical Center Incorporated | Clinic/Center | 7661 Lake Worth Rd, Lake Worth, FL 33467-2534 | 2020-07-20 |
| 1891312815 | Sacred Heart Asc, LLC | Clinic/Center | 1890 Summit Boulevard, Suite 210, Pensacola, FL 32503 | 2020-06-26 |
| 1578188983 | Miami Beach Surgery Center, LLC | Clinic/Center | 400 W 41st St Ste 512, Miami Beach, FL 33140-3517 | 2020-06-11 |
| 1346865078 | Panhandle Outpatient Surgery Center | Clinic/Center | 1502 Creighton Rd Ste C, Pensacola, FL 32504-7143 | 2020-06-09 |
| 1033734793 | Naples Suncoast Surgery Center LLC | Clinic/Center | 2500 Goodlette Frank Rd Ste 200, Naples, FL 34103-4608 | 2020-06-09 |
| 1710501879 | Hz Surgery Center LLC | Clinic/Center | 17085 Porter Road, Suite 110, Winter Garden, FL 34787 | 2020-06-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.