Organization
CORNERSTONE PRIMARY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES LEE (MANAGER/CEO)
(352) 343-1341
Entity
Organization
Contact information
Practice address
2445 LANE PARK RD, TAVARES, FL 32778-9648
(352) 343-1341
(352) 343-6115
Mailing address
2445 LANE PARK RD, TAVARES, FL 32778-9648
(352) 343-1341
(352) 343-6115
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/24/2020
Last updated
12/30/2020
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