| NPI | 1730275538 |
|---|---|
| Doing Business As | LAKE SHORE SPECIALTY GROUP |
| Entity Type | Organization |
| Authorized Contact | JODI MANSFIELD Sr. Vice President & COO 352-265-0440 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL 4258) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2008-05-07 |