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South Lake Medicine P A
Adult Medicine Physician in Clermont, Florida
NPI 1699940635

South Lake Medicine P A is an Adult Medicine Physician based in Clermont, FL and is specialized in Adult Medicine. South Lake Medicine P A practices in Clermont, FL. The NPI Number for South Lake Medicine P A is 1699940635 and holds a License No. ME83976 (Florida).

The current practice location address for South Lake Medicine P A is 3190 Citrus Tower Blvd, Clermont, FL and can be reached out via phone at 352-242-2282 and via fax at 352-242-2886.

Location: 3190 Citrus Tower Blvd, Clermont, FL, 34711-6802
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1699940635
Provider Name
South Lake Medicine P A
Credential
Provider Entity Type
Organization
Address
3190 Citrus Tower Blvd, Clermont, FL, 34711-6802
Phone Number
352-242-2282
Fax Number
352-242-2886
Provider Enumeration Date
04/29/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3190 Citrus Tower Blvd
City
Clermont
State
Florida
Zip
34711-6802
Phone Number
352-242-2282
Fax Number
352-242-2886
person
Provider Business Mailing Address Details
Address
3190 Citrus Tower Blvd
City
Clermont
State
Florida
Zip
34711-6802
Phone Number
352-242-2282
Fax Number
352-242-2886
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
Adult Medicine
Taxonomy
207QA0505X
License No.
ME83976 (Florida)
Definition
Definition to come.
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