| NPI | 1013261700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRESTON KYLE BARE Owner/ Doctor 352-369-6325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME110042) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2012-11-01 |
| Last Update Date | 2022-04-21 |