| NPI | 1043534670 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | MARK EDWARD WEIGLEY President 407-339-5959 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME002614) | 
| Enumeration Date | 2010-03-25 | 
| Last Update Date | 2010-03-25 |