South Lake Hospital Inc

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

SOUTH LAKE HOSPITAL INC

Practice address

1900 Don Wickham Dr
Clermont, FL 34711-1979

Phone

(352) 241-7275

Fax

(352) 241-7281

NPI assigned

Dec 13, 2007

Last updated

Aug 25, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Leslie Longacre

Title

Vice President

Phone

(407) 237-6393

Specialties & licenses 3

Addresses

Locations

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shene Corbin Allen, M.D.

  • Obstetrics & Gynecology Physician
  • Clermont, FL
  • NPI 1679779300
  NPD (past)
• May B Hamadeh, MD

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1861666208
  NPD (past)
• Richard Thomas Lee, CRNA

  • Certified Registered Nurse Anesthetist
  • Clermont, FL
  • NPI 1780787689
  NPD (past)
• Paul Schmidt, MD

  • Neurology Physician
  • Ormond Beach, FL
  • NPI 1245252444
  NPD (past)
• Mark Arthur Vollenweider, M.D.

  • Pulmonary Disease Physician
  • Orlando, FL
  • NPI 1356331698
  NPD (past)
• Marco Hallerbach, M.D.

  • Internal Medicine Physician
  • Lagrange, GA
  • NPI 1447466446
  NPD (past)
• Michael J. Kilbride, D.O.

  • Anesthesiology Physician
  • Aiken, SC
  • NPI 1225236045
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408924800000",
    "number": "1265615124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 DON WICKHAM DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111979",
            "telephone_number": "352-241-7275",
            "fax_number": "352-241-7281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 DON WICKHAM DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111979",
            "telephone_number": "352-241-7275",
            "fax_number": "352-241-7281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH LAKE HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-13",
        "last_updated": "2014-08-25",
        "status": "A",
        "authorized_official_last_name": "LONGACRE",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "407-237-6393"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Lake Cardiology, LLC
• South Lake Chiropractic PA
• South Lake Family Counseling Services
• South Lake Gastroenterology Inc
• South Lake Hospital Inc
• South Lake Hospital, Inc. (Orlando Health South Lake Hospital)
• South Lake Hospital, Inc. (South Lake Home Health)
• South Lake Hospital, Inc. (Orlando Health Cancer Institute)
• South Lake Internal Medicine PA
• South Lake Medical Center Inc

• Obstetrics & Gynecology Physician in Clermont, FL
• Providers in Clermont, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.