Lake Internal Medicine Associates
NPI 1679595649ActiveOrganization· Nurse Practitioner, Family· Eustis, FL
Nurse Practitioner, Family in Eustis, Florida, registered in NPPES in July 2006. The authorized official on file is Bonnie L. Demuth, Practice Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1679595649 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 25, 2006 |
| Last updated in NPPES | Sep 19, 2024 |
| Certified by provider | Sep 19, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (FL) |
|---|
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