Healthcare Provider Details

I. General information

NPI: 1881477412
Provider Name (Legal Business Name): LAKEWOOD RANCH ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2023
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8330 LAKEWOOD RANCH BLVD
LAKEWOOD RANCH FL
34202-5174
US

IV. Provider business mailing address

11161 STATE ROAD 70 E UNIT 110
LAKEWOOD RANCH FL
34202-9407
US

V. Phone/Fax

Practice location:
  • Phone: 941-290-5400
  • Fax: 941-289-2492
Mailing address:
  • Phone:
  • Fax: 941-289-2492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY BORSHEIM
Title or Position: MANAGING PARTNER
Credential:
Phone: 941-290-5400