Lakeside Edx LLC
NPI #1730763244 in Miramar Beach, Florida
Provider Information
- NPI Number
- 1730763244
- Entity Type
- Organization
- Organization Name
- Lakeside Edx LLC
- Primary Specialty
- Clinic/Center - Radiology
- Enumeration Date
- May 11, 2021
- Last Updated
- May 11, 2021
Practice Location
- Address
- 495 GRAND BLVD STE 206
- City
- Miramar Beach
- State
- Florida
- ZIP Code
- 32550-1897
- Phone
- (800) 416-1767
Authorized Official
- Name
- MR. THOMAS WINGER
- Title
- MEMBER
- Phone
- (800) 416-1767
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Radiology — Radiology |
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