Organization
LAKESIDE MED SUPPLIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KADICHA WILLIAMS (PRESIDENT)
(917) 436-2594
Entity
Organization
Contact information
Practice address
2415 SAND LAKE RD STE G, ORLANDO, FL 32809-7701
(917) 436-2594
Mailing address
2415 SAND LAKE RD STE G, ORLANDO, FL 32809-7701
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
01/09/2023
Last updated
01/09/2023
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