| South Lake Medicine P A | |
|
3190 Citrus Tower Blvd Clermont FL 34711-6802 | |
| (352) 242-2282 | |
| (352) 242-2886 |
| Full Name | South Lake Medicine P A |
|---|---|
| Speciality | Family Medicine |
| Location | 3190 Citrus Tower Blvd, Clermont, Florida |
| Authorized Official Name and Position | Hanxian Huang (OWNER) |
| Authorized Official Contact | 3522422282 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Lake Medicine P A 3190 Citrus Tower Blvd Clermont FL 34711-6802 Ph: (352) 242-2282 | South Lake Medicine P A 3190 Citrus Tower Blvd Clermont FL 34711-6802 Ph: (352) 242-2282 |
| NPI Number | 1699940635 |
|---|---|
| Provider Enumeration Date | 04/29/2008 |
| Last Update Date | 07/12/2010 |
| Medicare PECOS PAC ID | 4385713452 |
|---|---|
| Medicare Enrollment ID | O20080515000025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699940635 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | ME83976 (Florida) | Primary |
| Provider Name | Hanxian Huang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801810759 PECOS PAC ID: 5193628147 Enrollment ID: I20040128000900 |
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