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LAKE INTERNAL MEDICINE ASSOCIATES
NPI 1679595649
Nurse Practitioner - Family in Eustis, FL

Active since July 25, 2006CLIA 10D0681600 · Waiver
2101 PREVATT ST, EUSTIS, FL 32726(352) 589-4774(352) 589-5092 Get Directions Write a Review

NPPES record last updated: September 19, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 19, 2024, Aug 22, 2020 (2 updates tracked since 2020).

About Lake Internal Medicine Associates NPPES

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

LAKE INTERNAL MEDICINE ASSOCIATES (NPI 1679595649) is a healthcare organization registered as a family in Eustis, Florida and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through December 20, 2026 and lists Bonnie L Demuth, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1679595649
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameLAKE INTERNAL MEDICINE ASSOCIATES
Location Address2101 PREVATT STEustis, FL 32726-6131
Mailing Address2101 Prevatt StEustis, FL 32726-6131 · (352) 589-4774 · Fax (352) 589-5092
Phone(352) 589-4774
Fax(352) 589-5092
Organization SubpartNo
Authorized OfficialBonnie L DemuthPractice Manager · (352) 589-4774
Enumeration DateJuly 25, 2006
Last NPPES UpdateSeptember 19, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 19, 2024
✔ NPI 1679595649 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
2101 PREVATT ST, Eustis, FL 32726
Open in Google Maps ↗

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0681600

Lake Internal Medicine Associates PA · Eustis, FL
Active · expires Dec 20, 2026
CLIA Number10D0681600
Laboratory TypePhysician Office
Certificate Effective DateDecember 21, 2024
Certificate Expiration DateDecember 20, 2026
Laboratory DirectorSteven M. Tang
Laboratory Phone(352) 589-4774
Laboratory LocationLake Internal Medicine Associates PA2101 Prevatt St, Eustis, FL 32726
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

TINA D. WALKER ARNP
Nurse Practitioner (Family)
2101 PREVATT ST
EUSTIS, FL 32726
Lake County (352) 589-4774
ELIZABETH SHIRLEY
Nurse Practitioner (Family)
2101 PREVATT ST
EUSTIS, FL 32726
Lake County (352) 589-4774
ROBIN NIELSEN APRN
Nurse Practitioner (Family)
2101 PREVATT ST
EUSTIS, FL 32726
Lake County (352) 589-4774

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 Internal Medicine Associates's NPI number?

The NPI number for Lake Internal Medicine Associates is 1679595649. It was assigned to this organization in the NPPES registry on July 25, 2006.

Where is Lake Internal Medicine Associates located?

Lake Internal Medicine Associates is located at 2101 Prevatt St, Eustis, FL 32726. The listed phone number is (352) 589-4774.

What is Lake Internal Medicine Associates's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Lake Internal Medicine Associates hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0681600) is associated with this NPI, valid through December 20, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Lake Internal Medicine Associates accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Lake Internal Medicine Associates as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lake Internal Medicine Associates was last updated on September 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.