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LAKE CITY REGIONAL MEDICAL GROUP LLC NPI 1184910036


NPI Information

NPI: 1184910036
Provider Name: LAKE CITY REGIONAL MEDICAL GROUP LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 10D0938418

Address:
4225 NW AMERICAN LN
LAKE CITY, FL
ZIP 32055
Phone: (386) 758-6141
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LAKE CITY REGIONAL MEDICAL GROUP LLC is a family medicine in Lake City, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. LAKE CITY REGIONAL MEDICAL GROUP LLC NPI is 1184910036. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4225 NW AMERICAN LN
LAKE CITY, FL
ZIP 32055-841
Phone: (386) 758-6141
Fax: (386) 758-6140

The provider's authorized official is John Mark Rodkey .
The authorized official title is Vice President and has the following contact phone number (850) 523-3816.

The CLIA number assigned to this NPI record is 10D0938418 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/20/2011 and was last updated on 11/10/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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