OrganizationActive
South Lake Hospital Inc
NPI 1265615124 · Obstetrics & Gynecology Physician · Clermont, FL
Provider details
- NPI number
- 1265615124
- Entity type
- Organization
- Primary specialty
- Obstetrics & Gynecology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Leslie Longacre, Vice President(407) 237-6393
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
- Urology Physician208800000X
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1900 Don Wickham Dr
Clermont, FL 34711-1979
Phone: (352) 241-7275
Fax: (352) 241-7281
Street-level locationGet directions
Mailing address
1900 Don Wickham Dr
Clermont, FL 34711-1979
Registry dates
- Enumerated
- 2007-12-13
- Last updated
- 2014-08-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.