| NPI | 1033191085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON BURDZY Managing Physician 239-275-5522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2024-08-13 |