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

Lakeshore Medical Care Center, Inc

Organization Preferred Provider Organization · NPI 1124195573

Lakeshore Medical Care Center, Inc is a Preferred Provider Organization in Jacksonville, Florida. Licensed in Florida. Registered with an NPI since 2006.

Licensed in
FL
In the registry since
2006
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4616 San Juan Ave
Jacksonville, FL 32210-3228
Phone: (904) 384-5385
Fax: (904) 388-5838
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Preferred Provider Organization (primary) Taxonomy 305R00000X · Licence 0042816 (FL)
Preferred Provider Organization Taxonomy 305R00000X · Licence ME0018387 (FL)

Record details

NPI number1124195573
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tracy Teagle — Office Manager · (904) 384-5385
NPI enumeratedNovember 29, 2006
Last updated in NPPESDecember 27, 2010
Mailing address4616 San Juan Ave, Jacksonville, FL 32210-3228

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