Provider Demographics
NPI:1699004259
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:VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUZIK
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:727-532-7644
Mailing Address - Street 1:7527 ULMERTON ROAD
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771
Mailing Address - Country:US
Mailing Address - Phone:727-535-7250
Mailing Address - Fax:727-535-5272
Practice Address - Street 1:5406 HOOVER BLVD
Practice Address - Street 2:SUITE 21
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-5330
Practice Address - Country:US
Practice Address - Phone:813-248-8149
Practice Address - Fax:813-884-7085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-10
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine