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

Lake Medical Group, LLC

Organization Case Manager/Care Coordinator · NPI 1215767496

Lake Medical Group, LLC is a Case Manager/Care Coordinator in Miami Lakes, Florida. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
11
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

14750 NW 77th Ct Ste 304
Miami Lakes, FL 33016-1537
Phone: (305) 507-4400
Fax: (305) 826-2840
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Multi-Specialty Clinic/Center (primary) Taxonomy 261QM1300X
Case Manager/Care Coordinator Taxonomy 171M00000X
Physical Medicine & Rehabilitation Physician Taxonomy 208100000X
Pain Medicine Physician Taxonomy 208VP0000X
Adult Day Care Clinic/Center Taxonomy 261QA0600X
Infusion Therapy Clinic/Center Taxonomy 261QI0500X
Comprehensive Outpatient Rehabilitation Facility (CORF) Taxonomy 261QR0401X
Occupational Medicine Clinic/Center Taxonomy 261QX0100X
Clinical Medical Laboratory Taxonomy 291U00000X
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier Taxonomy 335V00000X

Record details

NPI number1215767496
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Alfonso Gonzalez — President · (305) 507-4400
NPI enumeratedAugust 3, 2024
Last updated in NPPESAugust 3, 2024
Certification dateAugust 3, 2024
Mailing address14750 Nw 77th Ct Ste 304, Miami Lakes, FL 33016-1537

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