LAKE BEHAVIORAL HEALTH MANAGEMENT


Address: 225 W Canton Ave Ste 600, Winter Park, FL 32789-3181
Phone: 4076228086

LAKE BEHAVIORAL HEALTH MANAGEMENT (NPI# 1356811897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1356811897
Entity Type Organization
Organization Name LAKE BEHAVIORAL HEALTH MANAGEMENT
Practice Address 225 W Canton Ave Ste 600
Winter Park
FL 32789-3181
Practice Telephone 4076228086
Mailing Telephone 4076228086
Enumeration Date 2018-11-27
Last Update Date 2018-11-27
Authorized Official Name DAVID CORDDRY (OWNER)
Authorized Official Telephone 4076228086
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207RG0300X Internal Medicine
Specialization: Geriatric Medicine
Allopathic & Osteopathic Physicians
Y 2084P0805X Psychiatry & Neurology
Specialization: Geriatric Psychiatry
Allopathic & Osteopathic Physicians

Office Location

Street Address 225 W CANTON AVE STE 600
City WINTER PARK
State FL
Zip Code 32789-3181

Providers in the same zip code

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Taxonomy Information

Taxonomy Code 2084P0805X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Geriatric Psychiatry

Taxonomy Definition

Geriatric Psychiatry is a subspecialty with psychiatric expertise in prevention, evaluation, diagnosis and treatment of mental and emotional disorders in the elderly, and improvement of psychiatric care for healthy and ill elderly patients.
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition]

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1558609156 Milagros C. Pescador Psychiatry & Neurology 5208 Touraine Dr, Tallahassee, FL 32308-5934 2013-01-17
1992063002 Marilyn Horvath Md Pa Psychiatry & Neurology 4317 Sw 186th Ave, Miramar, FL 33029-2772 2012-04-26
1295044873 Kelly L Dunn Md Pa Psychiatry & Neurology 1696 W Hibiscus Blvd Ste A, Melbourne, FL 32901-2638 2010-09-30
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Competitor

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City WINTER PARK
Zip Code 32789

Improve Information

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Dataset Information

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.

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