# LAKESIDE OCCUPATIONAL MEDICAL CENTERS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770780272
- **Authorized official:** SANDRA L. DRIVER R.N. (VICE PRESIDENT OF OPERATIONS)
- **Authorized official phone:** (727) 532-7647

## Contact information

- **Practice address:** 1750 N 50TH ST, TAMPA, FL 33619-3104
- **Practice address phone:** (813) 247-4489
- **Practice address fax:** (813) 247-4480
- **Mailing address:** 7527 ULMERTON RD, LARGO, FL 33771-4548
- **Mailing address phone:** (727) 586-0138
- **Mailing address fax:** (727) 586-6954

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/28/2007
- **Last updated:** 07/21/2009