Organization · Type 2 NPI
South Lake Primary Care P A
Primary Care Clinic/Center · Clermont, FL
NPI number
1053613232
Active
Practice location
1503 Sunrise Plaza Dr
Clermont, FL 34714-6200
Fax (352) 243-3804
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Clinic/Center Primary | 261QP2300X | ME0071348 (FL) |
Primary Care Clinic/Center: Definition to come...
Another provider at this address
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About NPI 1053613232
South Lake Primary Care P A's National Provider Identifier is 1053613232, issued on Nov 22, 2010. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Clermont, FL. The record was last updated on Aug 30, 2013.