Organization
SUN 'N LAKE MEDICAL GROUP,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAISA CAMILO (OWNER)
(863) 385-2659
Entity
Organization
Contact information
Practice address
511 W INTERLAKE BLVD, LAKE PLACID, FL 33852-0703
(863) 699-1220
(863) 699-1811
Mailing address
511 W INTERLAKE BLVD, LAKE PLACID, FL 33852-0703
(863) 699-1220
(863) 699-1811
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
ME61030
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160064
HEALTHESE
FL
01
—
220402
HEALTHESE
FL
01
—
23511
BCBS
FL
05
—
373302500
—
FL
01
—
ME61030
MEDICAL LICENSE
FL
Enumeration date
11/14/2007
Last updated
10/21/2025
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