LAKESHORE MEDICAL CARE CENTER, INC (NPI# 1124195573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124195573 |
| Entity Type | Organization |
| Organization Name | LAKESHORE MEDICAL CARE CENTER, INC |
| Practice Address |
4616 San Juan Ave Jacksonville FL 32210-3228 |
| Practice Telephone | 9043845385 |
| Practice Fax Number | 9043885838 |
| Mailing Telephone | 9043845385 |
| Mailing Fax Number | 9043885838 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2010-12-27 |
| Authorized Official Name | MISS TRACY TEAGLE (OFFICE MANAGER) |
| Authorized Official Telephone | 9043845385 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 305R00000X | Preferred Provider Organization | ME0018387 | FL | Managed Care Organizations |
| Y | 305R00000X | Preferred Provider Organization | 0042816 | FL | Managed Care Organizations |
| Street Address |
4616 SAN JUAN AVE |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32210-3228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326604729 | Finding Balance Counseling, LLC | Counselor | 4705 Palmer Ave, Jacksonville, FL 32210 | 2019-05-13 |
| 1609349620 | Jennifer Lash | Counselor | 4705 Palmer Avenue, Jacksonville, FL 32210 | 2019-01-03 |
| 1588147854 | Alan Craig Ashkinazy | Chiropractor | 5233 Ricker Rd Ste 102, Jacksonville, FL 32210 | 2018-09-12 |
| 1841781671 | Amanda Rodriguez-medina | Chiropractor | 6640 103rd St, Jacksonville, FL 32210 | 2018-05-29 |
| 1518457357 | Vicki Teal | Nurse Practitioner | 6488 103rd Street, Suite A, Jacksonville, FL 32210 | 2018-05-17 |
| 1811412539 | River City Companionship LLC | Clinic/Center | 7857 Delaroche Drive, Jacksonville, FL 32210 | 2017-08-03 |
| 1306366216 | Always Straight From The Heart | Homemaker | 6511 Betsy Court, Jacksonville, FL 32210 | 2017-06-21 |
| 1720538556 | Total Renal Care Inc | Clinic/Center | 5276 Blanding Blvd Ste 26, Jacksonville, FL 32210 | 2016-10-05 |
| 1700333978 | Recovery Counseling and More Inc | Clinic/Center | 4570 Saint Johns Ave, Ste B, Jacksonville, FL 32210 | 2016-09-06 |
| 1831645662 | Drucilla Young | Nurse's Aide | 1700 Blanding Blvd. 68n, Jacksonville, FL 32210 | 2016-08-31 |
| Find all providers in zip 32210 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891188173 | Julington Creek Pediatrics | Preferred Provider Organization | 774 State Road 13 Ste 6, Jacksonville, FL 32259-3815 | 2015-03-11 |
| 1760881163 | First Coast Medical Associates LLC | Preferred Provider Organization | 13241 Bartram Park Blvd Unit 413, Jacksonville, FL 32258-5237 | 2014-08-21 |
| 1891031910 | Mandarin Family Medicine, P.a. | Preferred Provider Organization | 12276-210 San Jose Blvd, Jacksonville, FL 32223 | 2012-12-18 |
| 1487737441 | Midtown Dental of Jacksonville | Preferred Provider Organization | 2801 Saint Johns Bluff Rd S, Suite 1, Jacksonville, FL 32246-3761 | 2006-10-23 |
| 1609241918 | Lysandro O. Tapnio Dmd Pa | Preferred Provider Organization | 9272 Arlington Expy, Jacksonville, FL 32225-8212 | 2015-12-11 |
| 1306189683 | T & R Inc | Preferred Provider Organization | 4131 University Blvd S Ste 4a, Jacksonville, FL 32216-4322 | 2013-04-04 |
| 1922361732 | Psi Family Services, Inc. | Preferred Provider Organization | 3890 Dunn Ave, 1104, Jacksonville, FL 32218-6428 | 2012-06-18 |
| 1932475167 | Medsports Promassage | Preferred Provider Organization | 3491 Pall Mall Dr, Suite 104, Jacksonville, FL 32257-5449 | 2012-04-02 |
| 1992019640 | Live Well M.d. | Preferred Provider Organization | 11512 Lake Mead Ave, Building 521, Jacksonville, FL 32256-9680 | 2010-08-04 |
| 1487891859 | Lymphedema Care Center of North Florida, Inc. | Preferred Provider Organization | 8563 Argyle Business Loop, Suite #2, Jacksonville, FL 32244-6668 | 2009-01-07 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32210 |
Please comment or provide details below to improve the information on LAKESHORE MEDICAL CARE CENTER, INC.
| 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.