| NPI | 1003385055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELIX C AGBO Owner 352-753-2224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2018-11-20 |
| Last Update Date | 2018-11-20 |