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Organization
NORTH LAKE PRIMARY CARE, P.A.
Active
Organization
NORTH LAKE PRIMARY CARE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEREMY E. CREECH ARNP (PROPRIETOR)
(352) 516-8931
Entity
Organization
Contact information
Practice address
8022 SAINT JAMES WAY, MOUNT DORA, FL 32757-9134
(352) 516-8931
Mailing address
8022 SAINT JAMES WAY, MOUNT DORA, FL 32757-9134
(352) 516-8931
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
363L00000X
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009259700
—
FL
Enumeration date
12/03/2014
Last updated
12/03/2014
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