Organization Name: | LAKESHORE MEDICAL CARE CENTER, INC |
NPI Number: | 1124195573 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TRACY TEAGLE (OFFICE MANAGER) |
Mailing Address: | 4616 San Juan Ave Jacksonville |
State: | FL US |
Postal Code: | 322103228 |
Phone Number: | 9043845385 |
Fax Number: | 9043885838 |
NPI Enumeration Date: | 11/29/2006 |
NPI Last Update Date: | 12/27/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 305R00000X |
License Number: | ME0018387 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Managed Care Organizations |
Taxonomy Classification: | Preferred Provider Organization |
Taxonomy Specialization: | |
Taxonomy Definition: | 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. |