| NPI | 1003812686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE M. BABB Billing Manager 239-263-1717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 1067) |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2022-07-21 |