EAST LAKE MEDICAL CLINIC is a primary care clinic center in Saint Cloud, FL. EAST LAKE MEDICAL CLINIC NPI is 1790124741. The provider is registered as an organization entity type.
The provider's business location address is:
4737 OLD CANOE CREEK RD
SAINT CLOUD, FL
ZIP 34769-400
Phone: (407) 705-3222
The provider's authorized official is Dustin Ly .
The authorized official title is President and has the following contact phone number (407) 705-3222.
The CLIA number assigned to this NPI record is 10D2256891 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 6/21/2013 and was last updated on 6/21/2013.