Provider Demographics
NPI:1730059478
Name:LAKESIDE KIDNEY CARE, LLC
Entity type:Organization
Organization Name:LAKESIDE KIDNEY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUBNA
Authorized Official - Middle Name:ASLAM
Authorized Official - Last Name:RASHID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-993-8445
Mailing Address - Street 1:17424 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MONTVERDE
Mailing Address - State:FL
Mailing Address - Zip Code:34756-3272
Mailing Address - Country:US
Mailing Address - Phone:201-993-8445
Mailing Address - Fax:201-993-8445
Practice Address - Street 1:3631 W BURLEIGH BLVD
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-5803
Practice Address - Country:US
Practice Address - Phone:352-742-0025
Practice Address - Fax:352-742-0025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-07
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty