| NPI | 1063850295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY SIBISKI Executive Vice President 352-265-8017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363L00000X Nurse Practitioner | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2020-11-24 |