| NPI | 1023786928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAE ANN ANTONUCCI Owner 941-662-6750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2021-09-03 |
| Last Update Date | 2021-09-03 |