Provider Demographics
NPI:1447553334
Name:LAKESIDE MEDICAL CENTERS, INC.
Entity type:Organization
Organization Name:LAKESIDE MEDICAL CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUZIK
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:727-532-7644
Mailing Address - Street 1:1750 N BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-3103
Mailing Address - Country:US
Mailing Address - Phone:863-533-2030
Mailing Address - Fax:
Practice Address - Street 1:1750 N BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-3103
Practice Address - Country:US
Practice Address - Phone:863-533-2030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-15
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine