Organization · Type 2 NPI

Shands at Lake Shore Inc

Clinic/Center · Lake City, FL

NPI number 1497854186 Active

Practice location

348 NE Methodist Ter, Suite 101
Lake City, FL 32055-3409

Call (386) 755-4007 Map

Fax (352) 733-0069

Mailing address

720 SW 2nd Ave, Suite 360C
Gainesville, FL 32601-6271

Specialties and licenses

Taxonomy	Code	License
Clinic/Center Primary	261Q00000X	None listed
Multi-Specialty Clinic/Center	261QM1300X	None listed

Clinic/Center: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

2 other providers at this address

Other clinic/center providers in Lake City

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NPI record

NPI: 1497854186
Entity type: Organization (Type 2)
Issued: Sep 21, 2006
Last updated: May 7, 2008
Status: Active
Subpart: Yes of Shands at Lake Shore Inc

Other names

<unavail>
Lake Shore Orthopedic Specialists · doing business as

Authorized official

Ms. Jodi Mansfield
Sr. Vice President & COO
(352) 265-0440

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1497854186

Shands at Lake Shore Inc's National Provider Identifier is 1497854186, issued on Sep 21, 2006. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Lake City, FL. The record was last updated on May 7, 2008.