| NPI | 1053550749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARRY VASSILAKIS Owner 386-668-9622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: FL CH8852) |
| Enumeration Date | 2009-02-19 |
| Last Update Date | 2009-02-19 |