| NPI | 1033804661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLEY MARIE BALBUENA Director Of Operations 352-513-9265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2023-04-11 |