SOUTH LAKE PRIMARY CARE P A NPI 1053613232

NPI Information

SOUTH LAKE PRIMARY CARE P A is a primary care clinic center in Clermont, FL. SOUTH LAKE PRIMARY CARE P A NPI is 1053613232. The provider is registered as an organization entity type.

The provider's business location address is:

1503 SUNRISE PLAZA DR
CLERMONT, FL
ZIP 34714-200
Phone: (352) 243-3800
Fax: (352) 243-3804

The provider's authorized official is Ramon Sueiro .
The authorized official title is Md and has the following contact phone number (352) 243-3800.

The enumeration date for this NPI number is 11/22/2010 and was last updated on 8/30/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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