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LAKE FAMILY MEDICINE & IMAGING
NPI 1164018743
Family Medicine in Sanford, FL

Active since December 17, 2020
1403 MEDICAL PLAZA DR STE 100, SANFORD, FL 32771(407) 559-5100(407) 559-5110 Get Directions Write a Review

NPPES record last updated: December 17, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lake Family Medicine & Imaging NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE FAMILY MEDICINE & IMAGING (NPI 1164018743) is a healthcare organization registered as a family medicine in Sanford, Florida and active in the NPI registry since December 2020. The organization lists Raj Kandavanam, Owner, as its authorized official.

NPPES Registry Identity

NPI1164018743
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameLAKE FAMILY MEDICINE & IMAGING
Location Address1403 MEDICAL PLAZA DR STE 100Sanford, FL 32771-1085
Mailing Address1403 Medical Plaza Dr Ste 100Sanford, FL 32771-1085 · (407) 559-5100 · Fax (407) 559-5110
Phone(407) 559-5100
Fax(407) 559-5110
Organization SubpartNo
Authorized OfficialRaj KandavanamOwner · (407) 559-5100
Enumeration DateDecember 17, 2020
NPPES CertifiedDecember 17, 2020
✔ NPI 1164018743 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1403 MEDICAL PLAZA DR STE 100, Sanford, FL 32771
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lake Family Medicine & Imaging's NPI number?

The NPI number for Lake Family Medicine & Imaging is 1164018743. It was assigned to this organization in the NPPES registry on December 17, 2020.

Where is Lake Family Medicine & Imaging located?

Lake Family Medicine & Imaging is located at 1403 Medical Plaza Dr Ste 100, Sanford, FL 32771. The listed phone number is (407) 559-5100.

What is Lake Family Medicine & Imaging's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Lake Family Medicine & Imaging was last updated on December 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.