LAKELAND DERMATOLOGY (NPI# 1255403762) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255403762 |
| Entity Type | Organization |
| Organization Name | LAKELAND DERMATOLOGY |
| Practice Address |
202 Lake Miriam Dr Ste S1 Lakeland FL 33813-2188 |
| Practice Telephone | 8636472333 |
| Practice Fax Number | 8633931995 |
| Mailing Telephone | 8636472333 |
| Mailing Fax Number | 8633931995 |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2010-11-04 |
| Authorized Official Name | DAVID W MURRAY (MD) |
| Authorized Official Telephone | 8636472333 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Street Address |
202 LAKE MIRIAM DR STE S1 |
| City | LAKELAND |
| State | FL |
| Zip Code | 33813-2188 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669453221 | Kim G Cole | Physician Assistant | 202 Lake Miriam Dr Ste S1, Lakeland, FL 33813-2188 | 2005-11-10 |
| 1457842197 | Caitlin R. Fredericka | Nurse Practitioner | 202 Lake Miriam Dr Ste S1, Lakeland, FL 33813-2188 | 2018-05-29 |
| 1184961419 | Bobbie Ferrell | Nurse Practitioner | 202 Lake Miriam Dr Ste S1, Lakeland, FL 33813-2188 | 2013-01-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427600030 | Genesis Vieyra Lopez | Nurse Practitioner | 631 Mid Florida Drive, Lakeland, FL 33813 | 2019-07-13 |
| 1306323340 | Sandrene Smart | Clinic/Center | 625 Commerce Dr. (suite 103), Lakeland, FL 33813 | 2018-07-23 |
| 1033560586 | Charles D. Llano, D.d.s. | Dentist | 320 West Highland Drive, Lakeland, FL 33813 | 2016-06-27 |
| 1417317389 | Eye Specialists of Mid-florida, Pa | Ophthalmology | 2004 Cr 540 A, Lakeland, FL 33813 | 2016-03-04 |
| 1609234905 | Care and Life LLC | In Home Supportive Care | 6526 Fox Tree Lane, Lakeland, FL 33813 | 2016-02-02 |
| 1558731158 | Lori Ann Smith | Nurse Practitioner | 6030 S. Florida Ave, Suite 110, Lakeland, FL 33813 | 2015-09-25 |
| 1891182143 | Advanced Integrated Care Organization, LLC | Health Maintenance Organization | 5423 S. Florida Ave, Lakeland, FL 33813 | 2015-04-23 |
| 1902292352 | Central Health Associates | Internal Medicine | 4925 Old Rd 37, Lakeland, FL 33813 | 2015-04-13 |
| 1134542848 | Gledia Lovering | Dietitian, Registered | 6420 Highlands In The Woods St, Lakeland, FL 33813 | 2014-01-31 |
| 1134556368 | Billy Rogers | Nurse Anesthetist, Certified Registered | 4513 Orangewood Loop W., Lakeland, FL 33813 | 2013-10-02 |
| Find all providers in zip 33813 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669908836 | Integrative Physical Medicine of Lakeland LLC | Specialist | 1205 East Magnolia St, Suite 105, Lakeland, FL 33801 | 2017-05-10 |
| 1962867838 | Amanda Bennett | Specialist | 705 Central Parke Cir Apt 208, Lakeland, FL 33805-9590 | 2015-12-21 |
| 1730512252 | Tampa Obstetrics, P.a. | Specialist | 1525 Lakeland Hills Blvd, Lakeland, FL 33805-3203 | 2013-08-20 |
| 1720323512 | Select Physical Therapy | Specialist | 3317 Us Highway 98 S Ste 6, Lakeland, FL 33803-8316 | 2012-12-05 |
| 1871865980 | William Riley Kendrick Jr. | Specialist | 3358 Bentbrooke Cv, Lakeland, TN 38002-5746 | 2012-02-04 |
| 1255654554 | Hai Yang | Specialist | 6838 Huntington Hills Blvd, Lakeland, FL 33810-5378 | 2010-03-01 |
| 1366688954 | Jeanne Martha Raschke | Specialist | 315 Faye Cir N, Lakeland, FL 33813-1512 | 2009-01-02 |
| 1245486869 | King Fernand | Specialist | 2240 Us Highway 92 E, Lakeland, FL 33801-2448 | 2008-08-14 |
| 1043480502 | American Care of Tampa Inc. | Specialist | 2600 Industrial Park Dr, Suite C, Lakeland, FL 33801-7135 | 2008-03-11 |
| 1962556878 | North Lakeland Pain & Trauma Inc | Specialist | 5516 Us 98 North, Lakeland, FL 33809 | 2007-01-22 |
| Find all providers in LAKELAND | ||||
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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.