LAKE DIABETES SUPPLY, INC (NPI# 1568763696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568763696 |
| Entity Type | Organization |
| Organization Name | LAKE DIABETES SUPPLY, INC |
| Practice Address |
508 N Harbor City Blvd Melbourne FL 32935-6838 |
| Practice Telephone | 3212559800 |
| Practice Fax Number | 3217511145 |
| Mailing Telephone | 3212559800 |
| Mailing Fax Number | 3217511145 |
| Enumeration Date | 2010-11-05 |
| Last Update Date | 2010-11-05 |
| Authorized Official Name | MR. MICHAEL E. HENNESSY (PRESIDENT) |
| Authorized Official Telephone | 3212559800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174H00000X | Health Educator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326033648 | Lake Diabetes Supply, Inc | Durable Medical Equipment & Medical Supplies | 2150 Collier Ave, Suite R, Fort Myers, FL 33901-8129 | 2005-09-13 |
| 1861487191 | Lake Diabetes Supply, Inc | Durable Medical Equipment & Medical Supplies | 2555 S Atlantic Ave, Suite 1205, Daytona Beach Shores, FL 32118-5546 | 2005-09-13 |
| Street Address |
508 N HARBOR CITY BLVD |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32935-6838 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407412018 | Aleecia Estime | Nurse Practitioner | 401 N Wickham Rd Ste S, Melbourne, FL 32935 | 2019-05-20 |
| 1669948261 | Lisa Marie Sarkees | Social Worker | 1503 Spring Drive, Melbourne, FL 32935 | 2018-10-22 |
| 1407355399 | Eugene Slaughter | Case Manager/Care Coordinator | 1600 W Eau Gallie Blvd. Suite 201 F, Melbourne, FL 32935 | 2018-02-06 |
| 1588173173 | Gregory M Mcdermand | Respiratory Therapist, Certified | 2745 Revolution St, Unit 101, Melbourne, FL 32935 | 2017-09-26 |
| 1386173649 | M Shami | Nurse Practitioner | 401 N Wickham Rd. Suite S, Melbourne, FL 32935 | 2017-06-08 |
| 1588102297 | Chiro Choice A Limited Liability Company | Clinic/Center | 1310 W Eau Galle Blvd Ste A, Melbourne, FL 32935 | 2017-02-02 |
| 1124574835 | A Loving Touch Private Home Care | Home Health | 1595 Palmwood Drive, Melbourne, FL 32935 | 2016-09-01 |
| 1538616099 | Pedro Triana Villamil | Specialist/Technologist, Other | 1600 Sarno Rd. Suite 15, Melbourne, FL 32935 | 2016-09-01 |
| 1528424132 | Lisa Forsythe | Acupuncturist | 1250 W. Eau Gallie Blvd., Suite H, Melbourne, FL 32935 | 2016-01-12 |
| 1528432028 | Harbor City Pharmacy Inc | Pharmacy | 503 Harbor City Blvd., Melbourne, FL 32935 | 2015-11-20 |
| Find all providers in zip 32935 | ||||
| Taxonomy Code | 174H00000X |
| Grouping | Other Service Providers |
| Classification | Health Educator |
| Health educators work in a variety of settings providing education to individuals or groups of individuals on healthy behaviors, wellness, and health-related topics with the goal of preventing diseases and health problems. Health educators generally require a bachelor’s degree and may receive additional training, such as through mentoring, internships, or volunteer work. |
| Notes: Source: National Uniform Claim Committee, 2009 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558836924 | Nicole Phillips | Health Educator | 1040 Masterson St, Melbourne, FL 32935-6196 | 2018-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376142901 | International Health Awareness Center Inc | Health Educator | 1921 Grove Ave, Fort Myers, FL 33901-7924 | 2020-10-24 |
| 1235744673 | Stephanie Ann Pearson | Health Educator | 510 Se Dixie Hwy, Stuart, FL 34994-3045 | 2020-09-12 |
| 1922618842 | Christina Nicole Lewis | Health Educator | 3737 Saint Johns Bluff Rd S Apt 1514, Jacksonville, FL 32224-2608 | 2020-08-05 |
| 1396366886 | Erin Zimmer | Health Educator | 491 Lake Parker Ave, Lakeland, FL 33801 | 2020-05-06 |
| 1508492224 | Kimberly Poitier | Health Educator | 3005 E Elm St, Tampa, FL 33610-1534 | 2020-03-13 |
| 1124667928 | Nichola Nerina Orr | Health Educator | 2085 S Congress Ave, Palm Springs, FL 33406-7601 | 2019-12-27 |
| 1972148153 | Simone Hewitt | Health Educator | 3603 Inverrary Blvd W, Lauderhill, FL 33319-4947 | 2019-11-12 |
| 1881235596 | Julie Castaneda | Health Educator | 3401 Mission Bay Blvd Apt 299, Orlando, FL 32817-5115 | 2019-10-03 |
| 1598316705 | Sigrid Cartier | Health Educator | 2201 Beach Dr Se, Saint Petersburg, FL 33705-2841 | 2019-09-28 |
| 1275183303 | Brandi Lupton | Health Educator | 10910 Victoria Arbor Way, Temple Terrace, FL 33617-3126 | 2019-09-20 |
| Find all providers with the same taxonomy | ||||
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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.