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Organization
LAKE ENDOCRINOLOGY AND DIABETES, PLLC
Active
Organization
LAKE ENDOCRINOLOGY AND DIABETES, PLLC
Active
Other names
Lake Endocrinology Consulting, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN MATTHEW LAKE DO (AMBR)
(727) 477-1039
Entity
Organization
Contact information
Practice address
13123 66TH ST, LARGO, FL 33773-1812
(727) 477-1039
(727) 477-0498
Mailing address
13123 66TH ST, LARGO, FL 33773-1812
(727) 477-1039
(727) 477-0498
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
NULL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
OS9591
FL
Other
Enumeration date
03/12/2017
Last updated
05/02/2021
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