Organization
LAKE ENDOSCOPY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLIN LEMAISTRE (OFFICER/AUTHORIZED OFFICIAL)
(404) 781-2921
Entity
Organization
Contact information
Practice address
17355 SE 109TH TERRACE RD, SUMMERFIELD, FL 34491-8930
(352) 245-0846
Mailing address
17355 SE 109TH TERRACE RD, SUMMERFIELD, FL 34491
(352) 245-0846
(352) 245-7768
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
11/07/2016
Last updated
12/19/2025
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