Provider Demographics
NPI:1336588276
Name:LAKEVIEW MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:LAKEVIEW MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DIULYS
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-391-8529
Mailing Address - Street 1:3600 RED RD STE 601A
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-6016
Mailing Address - Country:US
Mailing Address - Phone:954-391-8529
Mailing Address - Fax:954-342-9479
Practice Address - Street 1:3600 RED RD STE 601A
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-6016
Practice Address - Country:US
Practice Address - Phone:954-391-8529
Practice Address - Fax:954-342-9479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-24
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC10683261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation