Organization
LAKESIDE FAMILY MEDICINE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD EDWARD REYNOLDS D.O. (PRESIDENT OF LAKESIDE FAMILY MEDICI)
(352) 589-5900
Entity
Organization
Contact information
Practice address
4685 N HIGHWAY 19A, MOUNT DORA, FL 32757-2039
(352) 589-5900
(352) 589-5904
Mailing address
4685 N HIGHWAY 19A, MOUNT DORA, FL 32757-2039
(352) 589-5900
(352) 589-5904
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/04/2008
Last updated
03/25/2013
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