{"npi":"1356820286","type":"NPI-2","status":"active","name":{"display":"Lakeside Medical LLC","other":[],"organization_name":"LAKESIDE MEDICAL LLC","authorised_official":"Armando De Feria"},"specialty":{"primary_taxonomy":"207R00000X","primary_taxonomy_description":"Internal Medicine","slug":"internal-medicine","schema_org_specialty":"Internal","all":[{"code":"207R00000X","description":"Internal Medicine","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"600 N HIATUS RD STE 203","city":"PEMBROKE PINES","state":"FL","postal_code":"330265207","country_code":"US","phone":"9543927157","fax":"9544434941"},{"purpose":"MAILING","street_1":"600 N HIATUS RD STE 203","city":"PEMBROKE PINES","state":"FL","postal_code":"330265207","country_code":"US","phone":"9543927157","fax":"9544434941"}],"license":null,"identifiers":[{"type_code":"01","label":"Other","value":"NONE","state":null,"issuer":"NONE"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20190709003017","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"FL","pac_id":"4789919028"}]},"enumeration_date":"2018-08-10","last_updated":"2018-08-10","_meta":{"source":"NPPES","snapshot_date":"2018-08-10","doc_url":"https://findmynpi.com/api"}}