Organization · Type 2 NPI

South Lake Internal Medicine PA

Adult Medicine Physician · Clermont, FL

NPI number 1801838313 Active

Practice location

1371 Citrus Tower Blvd
Clermont, FL 34711-1924

Fax (352) 243-1309

Mailing address

1101 Citrus Tower Blvd
Clermont, FL 34711-1905

Specialties and licenses

TaxonomyCodeLicense
Adult Medicine Physician Primary 207QA0505XNone listed

Adult Medicine Physician: The NUCC recommends this code not be used. Choose a more appropriate code.

4 other providers at this address

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About NPI 1801838313

South Lake Internal Medicine PA's National Provider Identifier is 1801838313, issued on Jun 11, 2006. The primary taxonomy on file is Adult Medicine Physician (207QA0505X), and the practice location is in Clermont, FL. The record was last updated on Sep 18, 2008.