| NPI | 1003167073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN CROKER Owner/Manager 386-316-5439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ARNP3333802) |
| Enumeration Date | 2012-09-30 |
| Last Update Date | 2012-10-05 |