| NPI | 1679732689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD EDWARD REYNOLDS President Of Lakeside Family Medici 352-589-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2013-03-25 |