| Cornerstone Primary Care, LLC | |
|
2445 Lane Park Rd Tavares FL 32778-9648 | |
| (352) 343-1341 | |
| (352) 343-6115 |
| Full Name | Cornerstone Primary Care, LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 2445 Lane Park Rd, Tavares, Florida |
| Authorized Official Name and Position | Charles Lee (MANAGER/CEO) |
| Authorized Official Contact | 3523431341 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cornerstone Primary Care, LLC 2445 Lane Park Rd Tavares FL 32778-9648 Ph: (352) 343-1341 | Cornerstone Primary Care, LLC 2445 Lane Park Rd Tavares FL 32778-9648 Ph: (352) 343-1341 |
| NPI Number | 1386278828 |
|---|---|
| Provider Enumeration Date | 02/24/2020 |
| Last Update Date | 12/30/2020 |
| Certification Date | 12/30/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386278828 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
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