| NPI | 1053347203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES S EBY Medical Director 239-936-1145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL ME0015824) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2013-02-04 |