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Organization
LAKESIDE MED LLC
Active
Organization
LAKESIDE MED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARMANDO ANTENOR DE FERIA MD (PRESIDENT)
(954) 392-7157
Entity
Organization
Contact information
Practice address
600 N HIATUS RD STE 203, PEMBROKE PINES, FL 33026-5207
(954) 392-7157
(954) 443-4941
Mailing address
600 N HIATUS RD STE 203, PEMBROKE PINES, FL 33026-5207
(954) 392-7157
(954) 443-4941
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
12/10/2024
Last updated
12/10/2024
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