| NPI | 1033357694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSAY NICOLE PETTY Office Manager 772-873-5552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: FL ME 62002) |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2009-02-04 |