| NPI | 1023608999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRE ANTENOR CEO 863-242-3322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2021-01-24 |
| Last Update Date | 2022-07-19 |