Organization
SOUTH LAKE PRIMARY CARE P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAMON SUEIRO MD (MD)
(352) 243-3800
Entity
Organization
Contact information
Practice address
1503 SUNRISE PLAZA DR, CLERMONT, FL 34714-6200
(352) 243-3800
(352) 243-3804
Mailing address
1503 SUNRISE PLAZA DR, CLERMONT, FL 34714-6200
(352) 243-3800
(352) 243-3804
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
ME0071348
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250594100
—
FL
Enumeration date
11/22/2010
Last updated
08/30/2013
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