LAKESHORE MEDICAL CARE CENTER, INC – Preferred Provider Organization, NPI 1124195573

LAKESHORE MEDICAL CARE CENTER, INC is a healthcare provider. based in Jacksonville, Florida. specializing in Preferred Provider Organization. The organization holds a License No. ME0018387 (FL). The NPI Number for LAKESHORE MEDICAL CARE CENTER, INC is 1124195573

Main info

Organization
Name
LAKESHORE MEDICAL CARE CENTER, INC
NPI
1124195573
Phone
(904) 384-5385
Address
4616 SAN JUAN AVE
Authorized Official
MISS TRACY TEAGLE OFFICE MANAGER
Enumeration Date
29 November 2006
Last Update Date
27 December 2010
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness75
Years active:19State licenses:2Digital endpointsOther names

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Provider Addresses for LAKESHORE MEDICAL CARE CENTER, INC

  • 4616, San Juan Avenue, Lake Shore, Jacksonville, Duval County, Florida, 32210, United States

    JACKSONVILLE, FL 322103228

    Phone: (904) 384-5385

    Fax: (904) 388-5838

    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)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

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

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

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

Insurance plans in this area (ZIP 32210)

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Reviews

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Frequently asked questions

What unique ID ties claims to LAKESHORE MEDICAL CARE CENTER, INC?
NPI 1124195573 is assigned to LAKESHORE MEDICAL CARE CENTER, INC under the national enumeration system.
Does this profile mean LAKESHORE MEDICAL CARE CENTER, INC is currently active?
Yes — LAKESHORE MEDICAL CARE CENTER, INC appears active in the national provider directory.
What field does LAKESHORE MEDICAL CARE CENTER, INC work in?
You can think of LAKESHORE MEDICAL CARE CENTER, INC as practicing within Preferred Provider Organization. Clinical services aligned with this taxonomy classification.
Where does public data place LAKESHORE MEDICAL CARE CENTER, INC?
The snapshot lists Jacksonville, Florida for LAKESHORE MEDICAL CARE CENTER, INC; download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Organization.

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