Provider Demographics
NPI:1578971388
Name:LAKESIDE OCCUPATIONAL MEDICAL CENTERS INC
Entity Type:Organization
Organization Name:LAKESIDE OCCUPATIONAL MEDICAL CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OPERATIONS/ASISSTANT MEDICAL DR
Authorized Official - Prefix:
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:N
Authorized Official - Last Name:GUZIK
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, ARNP
Authorized Official - Phone:727-532-7644
Mailing Address - Street 1:7527 ULMERTON RD
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-4548
Mailing Address - Country:US
Mailing Address - Phone:727-586-0138
Mailing Address - Fax:727-586-6954
Practice Address - Street 1:12120 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-5514
Practice Address - Country:US
Practice Address - Phone:352-596-8700
Practice Address - Fax:352-596-1972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME25396261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine