Provider Demographics
NPI:1841484979
Name:LAKEVIEW HEALTHCARE SYSTEM, LLC
Entity type:Organization
Organization Name:LAKEVIEW HEALTHCARE SYSTEM, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KHAI
Authorized Official - Middle Name:SHENG
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-735-3755
Mailing Address - Street 1:10250 SE 167TH PLACE RD UNIT 5
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34491-8682
Mailing Address - Country:US
Mailing Address - Phone:352-307-9925
Mailing Address - Fax:352-385-0033
Practice Address - Street 1:10250 SE 167TH PLACE ROAD
Practice Address - Street 2:SUITE 5
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491-8632
Practice Address - Country:US
Practice Address - Phone:352-307-9925
Practice Address - Fax:352-385-0033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265426100Medicaid