Organization
LAKE MARY MEDICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE K. CROSS MD (OWNER)
(407) 415-5796
Entity
Organization
Contact information
Practice address
4300 W LAKE MARY BLVD STE 1010-378, LAKE MARY, FL 32746-2060
(407) 415-5796
Mailing address
4300 W LAKE MARY BLVD STE 1010-378, LAKE MARY, FL 32746-2060
(407) 415-5796
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
ME89809
FL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
ME89809
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME89809
LICENSE
FL
Enumeration date
08/02/2017
Last updated
03/26/2019
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