Lakeshore Medical Care Center, INC
NPI #1124195573 in Jacksonville, Florida
Provider Information
- NPI Number
- 1124195573
- Entity Type
- Organization
- Organization Name
- Lakeshore Medical Care Center, INC
- Primary Specialty
- Preferred Provider Organization
- Enumeration Date
- Nov 29, 2006
- Last Updated
- Dec 27, 2010
Practice Location
- Address
- 4616 SAN JUAN AVE
- City
- Jacksonville
- State
- Florida
- ZIP Code
- 32210-3228
- Phone
- (904) 384-5385
Authorized Official
- Name
- MISS TRACY TEAGLE
- Title
- OFFICE MANAGER
- Phone
- (904) 384-5385
Specialties & Taxonomy Codes
| Specialty |
|---|
| Preferred Provider Organization |
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