| NPI | 1023141819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROLD J FADEM Medical Director 407-275-9334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME 75343) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME 8351) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2016-12-06 |