MEDICARE: LAKEWOOD RANCH ENTERPRISES LLC

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	208M00000X	Hospitalist Physician

General Provider Information

NPI Number	:	1881477412
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAKEWOOD RANCH ENTERPRISES LLC

Provider Business Mailing Address
First Line	:	11161 STATE ROAD 70 E UNIT 110
Second Line	:
City	:	LAKEWOOD RANCH
State	:	FL
Zip	:	34202-9407
Country	:	US
Telephone Number	:
Fax Number	:	941-289-2492

Provider Business Practice Location Address
First Line	:	8330 LAKEWOOD RANCH BLVD
Second Line	:
City	:	LAKEWOOD RANCH
State	:	FL
Zip	:	34202-5174
Country	:	US
Telephone Number	:	941-290-5400
Fax Number	:	941-289-2492

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	KIMBERLY BORSHEIM
Credential	:
Telephone Number	:	941-290-5400

Provider Enumeration Date	:	08/16/2023
Last Update Date	:	12/15/2025

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