1. Home
  2. Directory
  3. Florida
  4. Miami Lakes
  5. Clinic Center
  6. NPI Profile

LAKE MEDICAL GROUP, LLC
NPI 1215767496
Clinic/Center - Multi-Specialty in Miami Lakes, FL

Active since August 03, 2024
14750 NW 77TH CT STE 304, MIAMI LAKES, FL 33016(305) 507-4400(305) 826-2840 Get Directions Write a Review

NPPES record last updated: August 3, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Lake Medical Group, Llc NPPES

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

LAKE MEDICAL GROUP, LLC (NPI 1215767496) is a healthcare organization registered as a multi-specialty in Miami Lakes, Florida and active in the NPI registry since August 2024. The organization lists Alfonso Gonzalez, President, as its authorized official.

NPPES Registry Identity

NPI1215767496
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameLAKE MEDICAL GROUP, LLC
Location Address14750 NW 77TH CT STE 304Miami Lakes, FL 33016-1537
Mailing Address14750 Nw 77th Ct Ste 304Miami Lakes, FL 33016-1537 · (305) 507-4400 · Fax (305) 826-2840
Phone(305) 507-4400
Fax(305) 826-2840
Organization SubpartNo
Authorized OfficialAlfonso GonzalezPresident · (305) 507-4400
Enumeration DateAugust 3, 2024
NPPES CertifiedAugust 3, 2024
✔ NPI 1215767496 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 11

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X
Also ListedPain Medicine · Pain MedicineTaxonomy 208VP0000X
Also ListedClinic/Center · Adult Day CareTaxonomy 261QA0600X
Also ListedClinic/Center · Infusion TherapyTaxonomy 261QI0500X
Also ListedClinic/Center · Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy 261QR0401X
Also ListedClinic/Center · Occupational MedicineTaxonomy 261QX0100X
Also ListedClinical Medical LaboratoryTaxonomy 291U00000X
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPortable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy 335V00000X
14750 NW 77TH CT STE 304, Miami Lakes, FL 33016
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAKE MEDICAL GROUP, LLC
Clinic/Center
14750 NW 77TH CT STE 304
MIAMI LAKES, FL 33016
Miami-Dade County (305) 507-4400

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 Medical Group, LLC's NPI number?

The NPI number for Lake Medical Group, LLC is 1215767496. It was assigned to this organization in the NPPES registry on August 3, 2024.

Where is Lake Medical Group, LLC located?

Lake Medical Group, LLC is located at 14750 NW 77th Ct Ste 304, Miami Lakes, FL 33016. The listed phone number is (305) 507-4400.

What is Lake Medical Group, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

When was this NPI record last updated?

The NPPES record for Lake Medical Group, LLC was last updated on August 3, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.