South Lake Medicine P A in Clermont - Adult Medicine
South Lake Medicine P A - NPI 1699940635
South Lake Medicine P A is a Adult Medicine in Clermont, Florida. South Lake Medicine P A practices all healthcare services and medical treatments related to Adult Medicine. The NPI Number for South Lake Medicine P A is 1699940635. The last update date is 2010-07-12.
South Lake Medicine P A's current location address is 3190 Citrus Tower Blvd, Clermont, Florida. You can contact this provider via phone number 3522422282 and fax number 3522422886. The mailing address for South Lake Medicine P A is 3190 Citrus Tower Blvd, Clermont, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | South Lake Medicine P A |
|---|---|
| Address | 3190 Citrus Tower Blvd, Clermont, Florida |
| Phone Number | 3522422282 |
| Fax Number | 3522422886 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Huang Hanxian |
| Credentials | M.D., PH.D |
| Telephone Number | 3522422282 |
NPI Number Detail
| NPI Number | 1699940635 |
|---|---|
| Provider Enumeration Date | 2008-04-29 |
| Last Updated Date | 2010-07-12 |
Provider Mailing Address Detail
| Address | 3190 Citrus Tower Blvd |
|---|---|
| City | Clermont |
| State | Florida (FL) |
| Post Code | 347116802 |
| Phone Number | 3522422282 |
| Fax Number | 3522422886 |
Provider's Primary Taxonomy Detail
| Speciality | Adult Medicine |
|---|---|
| Taxonomy | 207Qa0505X |
| Licence No | ME83976 |
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Definition: The NUCC recommends this code not be used. Choose a more appropriate code. |
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What is the South Lake Medicine P A's 1699940635?
The South Lake Medicine P A's NPI (National Provider Identifier) Number is 1699940635. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where South Lake Medicine P A is located?
The South Lake Medicine P A is situated at the following address: 3190 Citrus Tower Blvd, Clermont, FL, 347116802.
What is South Lake Medicine P A's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The South Lake Medicine P A's specialized field of practice is Adult Medicine, and the corresponding taxonomy code that categorizes this area of specialization is 207Qa0505X.
On what date did the South Lake Medicine P A receive the assignment of its 1699940635 from the Centers for Medicare & Medicaid Services?
The South Lake Medicine P A was issued its 1699940635 by the Centers for Medicare & Medicaid Services on 2008-04-29.
When was the information pertaining to South Lake Medicine P A most recently updated or revised?
The details related to South Lake Medicine P A, including its address, specialty, and other relevant information, were last updated or revised on 2010-07-12.
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