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Contact Information

LAKE BEHAVIORAL HEALTH MANAGEMENT
225 W CANTON AVE STE 600
WINTER PARK, FL32789-3181
 Phone: 407-622-8086
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
 

Geriatric Medicine

207RG0300X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for LAKE BEHAVIORAL HEALTH MANAGEMENT

NPI Number 1356811897
LBN Legal business name LAKE BEHAVIORAL HEALTH MANAGEMENT
Authorized official DAVID CORDDRY - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/27/2018
Last updated 11/27/2018 - About 8 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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