| NPI | 1013293562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL A SLOAN Administrator 941-349-6583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL HCCE604622) |
| Enumeration Date | 2011-10-28 |
| Last Update Date | 2011-10-28 |