Organization
EHS AT LAKESIDE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH SCHEPPKE MD (PRESIDENT)
(561) 436-2291
Entity
Organization
Contact information
Practice address
39200 HOOKER HWY, BELLE GLADE, FL 33430-5368
(561) 996-6571
(386) 274-7801
Mailing address
PO BOX 9414, DAYTONA BEACH, FL 32120-9414
(386) 274-7800
(386) 274-7801
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
Other
Enumeration date
10/02/2018
Last updated
10/02/2018
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