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South Lake Gastroenterology Inc
Specialist in Clermont, Florida
NPI 1467647685

South Lake Gastroenterology Inc is a Specialist based in Clermont, FL. South Lake Gastroenterology Inc practices in Clermont, FL. The NPI Number for South Lake Gastroenterology Inc is 1467647685 and holds a License No. ME74082 (Florida).

The current practice location address for South Lake Gastroenterology Inc is 2040 Oakley Seaver Dr, Clermont, FL and can be reached out via phone at 352-242-1665 and via fax at 352-243-1649.

Location: 2040 Oakley Seaver Dr, Clermont, FL, 34712-0930
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1467647685
Provider Name
South Lake Gastroenterology Inc
Credential
Provider Entity Type
Organization
Address
2040 Oakley Seaver Dr, Clermont, FL, 34712-0930
Phone Number
352-242-1665
Fax Number
352-243-1649
Provider Enumeration Date
09/11/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
5858631 01 FL AETNA
E0302Z 01 FL MEDICARE INDIVIDUAL
256031300 05 FL
43437 01 FL FL BCBS
institution
Provider Business Practice Location Address Details
Address
2040 Oakley Seaver Dr
City
Clermont
State
Florida
Zip
34711-1962
Phone Number
352-242-1665
Fax Number
352-243-1649
person
Provider Business Mailing Address Details
Address
2040 Oakley Seaver Dr
City
Clermont
State
Florida
Zip
34711-1962
Phone Number
352-242-1665
Fax Number
352-243-1649
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
ME74082 (Florida)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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