| NPI | 1023425840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA A MILLER Owner 941-312-5650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL ME 112763) |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2014-07-14 |