Lakeshore Pediatrics Annex – Pediatrics Physician, NPI 1043260490

Lakeshore Pediatrics Annex is a healthcare provider. based in West palm beach, Florida. specializing in Pediatrics Physician. The NPI Number for Lakeshore Pediatrics Annex is 1043260490

Main info

Organization
Name
Lakeshore Pediatrics Annex
NPI
1043260490
Phone
(561) 844-9443
Address
4450 S TIFFANY DR
Authorized Official
DR. MICHAEL F GERVASI PRESIDENT & CEO D.O.
Enumeration Date
10 May 2006
Last Update Date
6 September 2011
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness80
Years active:20State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for Lakeshore Pediatrics Annex

  • 4450 S TIFFANY DR

    WEST PALM BEACH, FL 334073241

    Phone: (561) 844-9443

    Fax: (561) 844-1013

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

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Medicare Enrollment & Revalidation

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No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33407)

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Frequently asked questions

Can I cross-check Lakeshore Pediatrics Annex using NPI 1043260490?
NPI 1043260490 belongs to Lakeshore Pediatrics Annex; compare other details if you need extra assurance.
Is Lakeshore Pediatrics Annex shown as active in public data?
Registry records indicate Lakeshore Pediatrics Annex maintains an active NPI.
What area of care is associated with Lakeshore Pediatrics Annex?
Lakeshore Pediatrics Annex's record emphasizes Pediatrics Physician. Clinical services aligned with this taxonomy classification.
Is Lakeshore Pediatrics Annex located near West Palm Beach?
Lakeshore Pediatrics Annex currently maps to West Palm Beach, Florida in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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