Organization
SOUTH LAKE HOSPITAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANCE SEWELL (CFO)
(352) 394-4071
Entity
Organization
Contact information
Practice address
2145 DON WICKHAM DR, CLERMONT, FL 34711
(352) 536-8787
(352) 241-7124
Mailing address
1900 DON WICKHAM DR, CLERMONT, FL 34711-1979
(352) 394-4071
(352) 241-7124
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
4180
FL
Other
Enumeration date
02/02/2015
Last updated
06/05/2018
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