Lakeside Family Medicine, P.a.

NPI #1679732689 in Mount Dora, Florida

Provider Information

NPI Number: 1679732689
Entity Type: Organization
Organization Name: Lakeside Family Medicine, P.a.
Primary Specialty: Clinic/Center - Primary Care
Enumeration Date: Jun 4, 2008
Last Updated: Mar 25, 2013

Practice Location

Address: 4685 N HIGHWAY 19A
City: Mount Dora
State: Florida
ZIP Code: 32757-2039
Phone: (352) 589-5900

Authorized Official

Name: DR. GERALD EDWARD REYNOLDS, D.O.
Title: PRESIDENT OF LAKESIDE FAMILY MEDICI
Phone: (352) 589-5900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Primary Care — Primary Care	261QP2300X	Primary

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