South Lake Obstetrics & Gynecology, LLC
NPI 1497754121ActiveOrganization· Obstetrics & Gynecology· Clermont, FL
Obstetrics & Gynecology in Clermont, Florida, registered in NPPES in July 2005. The authorized official on file is Matthew Stephan Casavant, DO, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1497754121 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 15, 2005 |
| Last updated in NPPES | Mar 13, 2024 |
| Certified by provider | Mar 13, 2024 |
| Reactivated | Jan 28, 2008 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Obstetrics & Gynecology Primary | 207V00000X | OS8678 | FL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (FL) |
|---|
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