SOUTH LAKE PRIMARY CARE P A
NPI 1053613232
Clinic/Center - Primary Care in Clermont, FL

Active since November 22, 2010CLIA 10D0966029 · Waiver
1503 SUNRISE PLAZA DR, CLERMONT, FL 34714(352) 243-3800(352) 243-3804 Get Directions Write a Review

NPPES record last updated: August 30, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About South Lake Primary Care P A NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTH LAKE PRIMARY CARE P A (NPI 1053613232) is a healthcare organization registered as a primary care in Clermont, Florida and active in the NPI registry since November 2010. The organization holds a CLIA Waiver certificate valid through October 5, 2027 and lists Ramon Sueiro, Md, as its authorized official.

NPPES Registry Identity

NPI1053613232
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameSOUTH LAKE PRIMARY CARE P A
Location Address1503 SUNRISE PLAZA DRClermont, FL 34714-6200
Mailing Address1503 Sunrise Plaza DrClermont, FL 34714-6200 · (352) 243-3800 · Fax (352) 243-3804
Fax(352) 243-3804
Organization SubpartNo
Authorized OfficialRamon SueiroMd · (352) 243-3800
Enumeration DateNovember 22, 2010
Last NPPES UpdateAugust 30, 2013
NPI 1053613232 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License Licensed in FL · ME0071348
1503 SUNRISE PLAZA DR, Clermont, FL 34714

Other Identifiers 3

Medicare UPING35745FL
Medicaid250594100FL
Medicare PIN31611AFL

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0966029

South Lake Primary Care PA · Clermont, FL
Active · expires Oct 5, 2027
CLIA Number10D0966029
Laboratory TypePhysician Office
Certificate Effective DateOctober 6, 2025
Certificate Expiration DateOctober 5, 2027
Laboratory DirectorRamon Sueiro
Laboratory Phone(352) 243-3800
Laboratory LocationSouth Lake Primary Care PA1503 Sunrise Plaza Dr Ste 12, Clermont, FL 34714
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
1503 SUNRISE PLAZA DR
CLERMONT, FL 34714

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is South Lake Primary Care P A's NPI number?

The NPI number for South Lake Primary Care P A is 1053613232. It was assigned to this organization in the NPPES registry on November 22, 2010.

Where is South Lake Primary Care P A located?

South Lake Primary Care P A is located at 1503 Sunrise Plaza Dr, Clermont, FL 34714. The listed phone number is (352) 243-3800.

What is South Lake Primary Care P A's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does South Lake Primary Care P A hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0966029) is associated with this NPI, valid through October 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for South Lake Primary Care P A was last updated on August 30, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.