South Lake Hospital Inc | NPI 1265615124

Key facts

NPI: 1265615124
Entity type: Organization (NPI type 2)
Primary specialty: Obstetrics & Gynecology Physician 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
Organization subpart: No

Authorized official

Name: Leslie Longacre
Title: Vice President
Phone: (407) 237-6393

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Shene Corbin Allen, M.D. Obstetrics & Gynecology Physician · Clermont, FL · NPI 1679779300

NPD (past) OBSTETRICS & GYNECOLOGY
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)

National Provider Directory

Locations

1900 Don Wickham Dr
Ste 110
Clermont, FL 34711
Phone (352) 241-6460

1935 Don Wickham Dr
Clermont, FL 34711
Phone (352) 241-7144

16966 Cagan Ridge Blvd
Clermont, FL 34714
Phone (352) 536-8761

4401 S Orange Ave
Ste 113
Orlando, FL 32806

Networks

Freedom Health HMO Network
Plans: 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 Maximo (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)…

Specialties & licenses

Specialty (taxonomy)	Code	Primary
Endocrinology, Diabetes & Metabolism Physician Group: 193200000X MULTI-SPECIALTY GROUP	207RE0101X
Obstetrics & Gynecology Physician Group: 193200000X MULTI-SPECIALTY GROUP	207V00000X	Yes
Urology Physician Group: 193200000X MULTI-SPECIALTY GROUP	208800000X

Addresses

Primary practice location

1900 Don Wickham Dr
Clermont, FL 34711-1979

Mailing address

1900 Don Wickham Dr
Clermont, FL 34711-1979
Phone (352) 241-7275

Other providers in Clermont, FL

All providers in Clermont, FL · Obstetrics & Gynecology Physician in Florida

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2014. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.