OrganizationActive
Lakewood Ccl, LLC
NPI 1922575802 · Multi-Specialty Clinic/Center · Wildwood, FL
Provider details
- NPI number
- 1922575802
- Entity type
- Organization
- Primary specialty
- Multi-Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jose Rivera, Administrator(352) 643-9070
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(67/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
5571 E Sr 44 Ste 501
Wildwood, FL 34785-8282
Phone: (352) 643-9070
Fax: (352) 571-6787
Street-level locationGet directions
Mailing address
5571 E Sr 44 Ste 501
Wildwood, FL 34785-8282
Registry dates
- Enumerated
- 2018-10-29
- Last updated
- 2018-10-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.