Provider Demographics
NPI:1881312585
Name:LAKEVIEW PRIMARY CARE LLC
Entity type:Organization
Organization Name:LAKEVIEW PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:FIORE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:540-903-1780
Mailing Address - Street 1:48 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MINERAL
Mailing Address - State:VA
Mailing Address - Zip Code:23117-4417
Mailing Address - Country:US
Mailing Address - Phone:540-903-1780
Mailing Address - Fax:
Practice Address - Street 1:9942 KENTUCKY SPRINGS RD STE 22
Practice Address - Street 2:
Practice Address - City:MINERAL
Practice Address - State:VA
Practice Address - Zip Code:23117-4777
Practice Address - Country:US
Practice Address - Phone:540-903-4483
Practice Address - Fax:540-894-4001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care