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

Lake Shore Center for Aesthetics & Plastic Surgery PA

Organization Plastic Surgery Physician · NPI 1477982171

Lake Shore Center for Aesthetics & Plastic Surgery PA is a Plastic Surgery Physician in Lake City, Florida. Licensed in Florida. Registered with an NPI since 2013.

Licensed in
FL
In the registry since
2013
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

263 SW Professional Gln
Lake City, FL 32025-1105
Phone: (386) 755-6676
Fax: (386) 755-1667
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X · Licence ME 105501 (FL)

Record details

NPI number1477982171
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Melinda Keener — President · (386) 755-6676
NPI enumeratedNovember 4, 2013
Last updated in NPPESJanuary 7, 2014
Mailing address263 Sw Professional Gln, Lake City, FL 32025-1105