Organization
LAKE CITY SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLIN LEMAISTRE (OFFICER/AUTHORIZED OFFICIAL)
(214) 213-0732
Entity
Organization
Contact information
Practice address
208 SW PROSPERITY PLACE, LAKE CITY, FL 32024
(386) 487-3930
(386) 487-3935
Mailing address
208 SW PROSPERITY PLACE, LAKE CITY, FL 32024
(386) 487-3930
(386) 487-3935
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1046
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10-C0001276
ASC MEDICARE IDENTIFICATI
FL
Enumeration date
07/18/2007
Last updated
07/30/2025
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