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LAKE PEDIATRICS P. A.
NPI 1942367370
Clinic/Center - Rural Health in Mount Dora, FL

Active since January 03, 2007
4880 N HIGHWAY 19A STE 200, MOUNT DORA, FL 32757(352) 589-8111(352) 589-8111 Get Directions Write a Review

NPPES record last updated: November 12, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 12, 2025, Aug 11, 2025, Jan 11, 2022 (3 updates tracked since 2022).

About Lake Pediatrics P. A. NPPES

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

LAKE PEDIATRICS P. A. (NPI 1942367370), doing business as Lake Pediatrics, P.a., is a healthcare organization registered as a rural health in Mount Dora, Florida and active in the NPI registry since January 2007. The organization lists Donna Lynn Nettles, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1942367370
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameLAKE PEDIATRICS P. A.
Location Address4880 N HIGHWAY 19A STE 200Mount Dora, FL 32757-2018
Mailing Address4880 N Hwy 19 AMt Dora, FL 32757-2018 · (352) 589-8111 · Fax (352) 589-8495
Phone(352) 589-8111
Fax(352) 589-8111
Organization SubpartNo
Authorized OfficialDonna Lynn NettlesBilling Manager · (523) 638-4997
Enumeration DateJanuary 3, 2007
Last NPPES UpdateNovember 12, 20253 updates tracked since enumeration
NPPES CertifiedNovember 12, 2025
✔ NPI 1942367370 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedPediatricsTaxonomy 208000000X
4880 N HIGHWAY 19A STE 200, Mount Dora, FL 32757
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Other Names 1

Doing Business AsLake Pediatrics, P.a.

Other Identifiers 1

Medicaid126977000FL

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Other Providers at the Same Location NPPES 2

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

MRS. KAYCE ANN WALKER ARNP
Nurse Practitioner (Pediatrics)
4880 N HIGHWAY 19A STE 200
MOUNT DORA, FL 32757
Orange County (352) 589-8111
KELLI KRISTIANA GRADY APRN
Nurse Practitioner (Pediatrics)
4880 N HIGHWAY 19A STE 200
MOUNT DORA, FL 32757
Orange County (352) 589-8111

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 Pediatrics P. A.'s NPI number?

The NPI number for Lake Pediatrics P. A. is 1942367370. It was assigned to this organization in the NPPES registry on January 3, 2007. The provider is doing business as Lake Pediatrics, P.A..

Where is Lake Pediatrics P. A. located?

Lake Pediatrics P. A. is located at 4880 N Highway 19A Ste 200, Mount Dora, FL 32757. The listed phone number is (352) 589-8111.

What is Lake Pediatrics P. A.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

What insurance does Lake Pediatrics P. A. accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) and 1 other insurer list Lake Pediatrics P. A. 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 Pediatrics P. A. was last updated on November 12, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.