| NPI | 1013687110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN CLAUSSEN CEO 863-291-5110 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 152W00000X Optometrist | |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| Enumeration Date | 2021-09-20 |
| Last Update Date | 2025-05-07 |