# SOUTH LAKE MEDICINE P A

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699940635
- **Authorized official:** DR. HANXIAN HUANG M.D., PH.D. (OWNER)
- **Authorized official phone:** (352) 242-2282

## Contact information

- **Practice address:** 3190 CITRUS TOWER BLVD, CLERMONT, FL 34711-6802
- **Practice address phone:** (352) 242-2282
- **Practice address fax:** (352) 242-2886
- **Mailing address:** 3190 CITRUS TOWER BLVD, CLERMONT, FL 34711-6802
- **Mailing address phone:** (352) 242-2282
- **Mailing address fax:** (352) 242-2886

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | ME83976 | FL | Yes |

## Other

- **Enumeration date:** 04/29/2008
- **Last updated:** 07/12/2010