| NPI | 1003467960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGARDO CASTILLO Chief Medical Officer 239-368-7310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2019-09-23 |