Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Crater Lake Emergency Physicians LLC

Organization Emergency Medicine Physician · NPI 1194134031

Crater Lake Emergency Physicians LLC is an Emergency Medicine Physician in Lake City, Florida. Registered with an NPI since 2014.

In the registry since
2014
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

340 NW Commerce Dr
Lake City, FL 32055-4709
Phone: (469) 401-2386
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X

Record details

NPI number1194134031
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kathleen Kondas — Officer · (973) 251-1132
NPI enumeratedAugust 5, 2014
Last updated in NPPESDecember 21, 2020
Certification dateDecember 21, 2020
Mailing address13737 Noel Rd, Ste 1600, Dallas, TX 75240-1331

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