| NPI | 1053458455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE E MEDLEY Office Manager 352-622-9007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2020-07-21 |