Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

South Lake Obstetrics & Gynecology, LLC

Organization Obstetrics & Gynecology Physician · NPI 1497754121

South Lake Obstetrics & Gynecology, LLC is an Obstetrics & Gynecology Physician in Clermont, Florida. Licensed in Florida. Registered with an NPI since 2005.

Licensed in
FL
In the registry since
2005
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1900 Don Wickham Dr Ste 120
Clermont, FL 34711-1980
Phone: (352) 241-7050
Fax: (352) 241-7035
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence OS8678 (FL)

Record details

NPI number1497754121
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Matthew Casavant — Owner · (321) 436-8371
Other names South Lake Ob/Gyn And Advanced Surgery
NPI enumeratedJuly 15, 2005
Last updated in NPPESMarch 13, 2024
Certification dateMarch 13, 2024
Mailing address1900 Don Wickham Dr Ste 120, Clermont, FL 34711-1980

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