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Organization
LAKESIDE SURGERY LLC
Active
Organization
LAKESIDE SURGERY LLC
Active
Other names
Lakeside Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN LEHR (PRESIDENT)
(078) 938-2004
Entity
Organization
Contact information
Practice address
1825 N MILLS AVE, ORLANDO, FL 32803
(407) 206-2375
(407) 206-2377
Mailing address
1825 N MILLS AVE, ORLANDO, FL 32803
(407) 206-2375
(407) 206-2377
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
079231400
—
FL
01
—
306
WELLCARE
FL
01
—
490003489
MEDICARE RAILROAD
FL
01
—
638
BCBS
FL
Enumeration date
05/19/2006
Last updated
02/21/2022
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