| NPI | 1053747188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILAL KHODR Medical Director 352-213-1243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME0072652) |
| Enumeration Date | 2013-09-20 |
| Last Update Date | 2013-09-20 |