SOUTH LAKE HOSPITAL INC NPI 1265615124

NPI Information

NPI: 1265615124
Provider Name: SOUTH LAKE HOSPITAL INC
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization
Address:
1900 DON WICKHAM DR
CLERMONT, FL
ZIP 34711
Phone: (352) 241-7275
Get Directions

SOUTH LAKE HOSPITAL INC is an obstetrics gynecology in Clermont, FL. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. SOUTH LAKE HOSPITAL INC NPI is 1265615124. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1900 DON WICKHAM DR
CLERMONT, FL
ZIP 34711-979
Phone: (352) 241-7275
Fax: (352) 241-7281

The provider's authorized official is Leslie Longacre .
The authorized official title is Vice President and has the following contact phone number (407) 237-6393.

The enumeration date for this NPI number is 12/13/2007 and was last updated on 8/25/2014.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	207RE0101X	Internal Medicine	Endocrinology, Diabetes & Metabolism	No
2	208800000X	Urology		No
3	207V00000X	Obstetrics & Gynecology		Yes

Other Identifiers

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

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0051A	MEDICARE PIN	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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