Organization
CLERMONT INTERNAL AND COSMETIC MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDRISS ESTIME MD (OWNER/AUTHORIZED REP)
(352) 404-5174
Entity
Organization
Contact information
Practice address
290 CITRUS TOWER BLVD, SUITE 102, CLERMONT, FL 34711-2783
(352) 404-5174
(352) 678-3430
Mailing address
290 CITRUS TOWER BLVD, SUITE 102, CLERMONT, FL 34711-2783
(352) 404-5174
(352) 678-3430
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014748100
—
FL
Enumeration date
04/07/2015
Last updated
09/25/2015
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