| Sun 'n Lake Medical Group,pa | |
|
511 W Interlake Blvd Lake Placid FL 33852-0703 | |
| (863) 699-1220 | |
| (863) 699-1811 |
| Full Name | Sun 'n Lake Medical Group,pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 511 W Interlake Blvd, Lake Placid, Florida |
| Authorized Official Name and Position | Raisa Camilo (OWNER) |
| Authorized Official Contact | 8633852659 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sun 'n Lake Medical Group,pa 511 W Interlake Blvd Lake Placid FL 33852-0703 Ph: (863) 699-1220 | Sun 'n Lake Medical Group,pa 511 W Interlake Blvd Lake Placid FL 33852-0703 Ph: (863) 699-1220 |
| NPI Number | 1144400540 |
|---|---|
| Provider Enumeration Date | 11/14/2007 |
| Last Update Date | 10/21/2025 |
| Medicare PECOS PAC ID | 2668380841 |
|---|---|
| Medicare Enrollment ID | O20080909000441 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144400540 | NPI | - | NPPES |
| ME61030 | Other | FL | MEDICAL LICENSE |
| 23511 | Other | FL | BCBS |
| 160064 | Other | FL | HEALTHESE |
| 220402 | Other | FL | HEALTHESE |
| 373302500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | ME61030 (Florida) | Primary |
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