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
—
—
261QM2500X
Medical Specialty Clinic/Center
OS9591
FL
Other
Enumeration date
03/12/2017
Last updated
05/02/2021
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