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SOUTH LAKE OB/GYN
NPI 1497754121
Obstetrics & Gynecology in Clermont, FL

Active since July 15, 2005CLIA 10D0999175 · Microscopy
1099 CITRUS TOWER BLVD, STE 120, CLERMONT, FL 34711(352) 241-7050(352) 241-7035 Get Directions Write a Review

NPPES record last updated: January 28, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About South Lake Ob/gyn NPPES

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

SOUTH LAKE OB/GYN (NPI 1497754121), doing business as South Lake Ob/gyn And Advanced Surgery, is a healthcare organization registered as an obstetrics & gynecology in Clermont, Florida and active in the NPI registry since July 2005. The organization holds a CLIA Microscopy certificate valid through March 13, 2027 and lists Matthew Stephen Casavant, Owner, as its authorized official.

NPPES Registry Identity

NPI1497754121
Entity TypeOrganization
Primary Taxonomy207V00000X
Legal Business NameSOUTH LAKE OB/GYN
Location Address1099 CITRUS TOWER BLVD, STE 120Clermont, FL 34711
Mailing Address1099 Citrus Tower Blvd, Ste 120Clermont, FL 34711 · (352) 241-7050 · Fax (352) 241-7035
Phone(352) 241-7050
Fax(352) 241-7035
Organization SubpartNo
Authorized OfficialMatthew Stephen CasavantOwner · (352) 241-7050
Enumeration DateJuly 15, 2005
Last NPPES UpdateJanuary 28, 2008
✔ NPI 1497754121 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in FL · OS8678
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
1099 CITRUS TOWER BLVD, Clermont, FL 34711
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Other Names 1

Doing Business AsSouth Lake Ob/gyn And Advanced Surgery

Other Identifiers 3

Medicare UPINH54064FL
Medicare ID-Type UnspecifiedK3688FL
Medicare PINK3688FL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama.Insurance ›

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 for Provider-Performed Microscopy Procedures (PPMP) 10D0999175

South Lake Ob-Gyn · Clermont, FL
Active · expires Mar 13, 2027
CLIA Number10D0999175
Laboratory TypePhysician Office
Certificate Effective DateMarch 14, 2025
Certificate Expiration DateMarch 13, 2027
Laboratory DirectorMatthew S. Casavant
Laboratory Phone(352) 241-7050
Laboratory LocationSouth Lake Ob-Gyn1900 Don Wickham Dr Suite 120, Clermont, FL 34711
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 10

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

DR. MARTIN FISHER M.D.
Anesthesiology
1099 CITRUS TOWER BLVD
CLERMONT, FL 34711
Lake County (352) 394-4071
ROCKY MOUNTAIN HOLDINGS, LLC
Ambulance (Air Transport)
1099 CITRUS TOWER BLVD
CLERMONT, FL 34711
Lake County (888) 636-4438
MRS. JACQUELINE HELLER MILLER PA-C
Physician Assistant (Medical)
1099 CITRUS TOWER BLVD, STE 120
CLERMONT, FL 34711
Lake County (352) 241-7050
DR. DAVID SCOT GHIVIZZANI M.D.
Anesthesiology
1099 CITRUS TOWER BLVD
CLERMONT, FL 34711
Lake County (352) 394-4071
TERESA LAYMAN CRNA
Nurse Anesthetist, Certified Registered
1099 CITRUS TOWER BLVD
CLERMONT, FL 34711
Lake County (352) 243-9114
ERNESTO ZAVALETA, MD, PA
Internal Medicine
1099 CITRUS TOWER BLVD, SOUTH LAKE HOSPITAL
CLERMONT, FL 34711
Lake County (352) 241-9322
SOUTH LAKE ANESTHESIA SERVICES, P.A.
Nurse Anesthetist, Certified Registered
1099 CITRUS TOWER BLVD
CLERMONT, FL 34711
Lake County (352) 394-4071
MS. IMKE CASEY CRNA
Nurse Anesthetist, Certified Registered
1099 CITRUS TOWER BLVD
CLERMONT, FL 34711
Lake County (352) 404-9467

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 Ob/Gyn's NPI number?

The NPI number for South Lake Ob/Gyn is 1497754121. It was assigned to this organization in the NPPES registry on July 15, 2005. The provider is doing business as South Lake Ob/Gyn And Advanced Surgery.

Where is South Lake Ob/Gyn located?

South Lake Ob/Gyn is located at 1099 Citrus Tower Blvd Ste 120, Clermont, FL 34711. The listed phone number is (352) 241-7050.

What is South Lake Ob/Gyn's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Does South Lake Ob/Gyn hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 10D0999175) is associated with this NPI, valid through March 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does South Lake Ob/Gyn accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan and Ambetter of Alabama list South Lake Ob/Gyn as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for South Lake Ob/Gyn was last updated on January 28, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.