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9350 Us Highway 192 Ste 104 Clermont FL 34714-8231 | |
| (863) 256-5206 | |
| (863) 913-0534 |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 9350 Us Highway 192 Ste 104, Clermont, Florida |
| Authorized Official Name and Position | Jhenelle Lawson (OWNER) |
| Authorized Official Contact | 8632565206 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
9350 Us Highway 192 Ste 104 Clermont FL 34714-8231 Ph: (863) 256-5206 | 9350 Us Highway 192 Ste 104 Clermont FL 34714-8231 Ph: (863) 256-5206 |
| NPI Number | 1043954571 |
|---|---|
| Provider Enumeration Date | 04/21/2022 |
| Last Update Date | 11/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043954571 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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