Provider Demographics
NPI:1104017946
Name:TO YOUR HEALTH OF LAKE COUNTY INC
Entity Type:Organization
Organization Name:TO YOUR HEALTH OF LAKE COUNTY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:L
Authorized Official - Last Name:CARRASCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-326-5281
Mailing Address - Street 1:26540 ACE AVE
Mailing Address - Street 2:SUITE 108C
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-8279
Mailing Address - Country:US
Mailing Address - Phone:352-326-5281
Mailing Address - Fax:352-323-1761
Practice Address - Street 1:26540 ACE AVE
Practice Address - Street 2:SUITE 108C
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-8279
Practice Address - Country:US
Practice Address - Phone:352-326-5281
Practice Address - Fax:352-323-1761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70698207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAH801Medicare PIN