MEDICARE: LAKEISHA LIND GUILLIAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	APRN11029064	FL

General Provider Information

NPI Number	:	1336918358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAKEISHA LIND GUILLIAM

Provider Business Mailing Address
First Line	:	2228 S KIRKMAN RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32811-2308
Country	:	US
Telephone Number	:	407-615-8180
Fax Number	:	407-615-8182

Provider Business Practice Location Address
First Line	:	2228 S KIRKMAN RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32811-2308
Country	:	US
Telephone Number	:	407-615-8180
Fax Number	:	407-615-8182

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2024
Last Update Date	:	08/13/2025

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Directions to “ LAKEISHA LIND GUILLIAM ” Practice Location

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