Provider Demographics
NPI:1871041681
Name:LAKESIDE ENDOCRINE ASSOCIATES, INC
Entity Type:Organization
Organization Name:LAKESIDE ENDOCRINE ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NEIME
Authorized Official - Middle Name:O
Authorized Official - Last Name:SANCHEZ-GIVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-237-4390
Mailing Address - Street 1:1667 N CLYDE MORRIS BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-5500
Mailing Address - Country:US
Mailing Address - Phone:386-274-1944
Mailing Address - Fax:
Practice Address - Street 1:1667 N CLYDE MORRIS BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-5500
Practice Address - Country:US
Practice Address - Phone:386-274-1944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-21
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty