South Lake Pediatrics, P.a.

NPI #1699076901 in Clermont, Florida

Provider Information

NPI Number: 1699076901
Entity Type: Organization
Organization Name: South Lake Pediatrics, P.a.
Primary Specialty: Pediatrics
Enumeration Date: Nov 3, 2010
Last Updated: Nov 3, 2010

Practice Location

Address: 3155 CITRUS TOWER BLVD
Address 2: BLDG.# 1
City: Clermont
State: Florida
ZIP Code: 34711-6803
Phone: (352) 242-1500

Authorized Official

Name: DR. ADINARAYANAMURTHY NALLAMSHETTY, MD
Title: PRESIDENT
Phone: (352) 242-1500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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