| NPI | 1073212957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE MARTINEZ Senior Credentialing Professional 407-447-7120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208D00000X General Practice | |
| Enumeration Date | 2023-02-28 |
| Last Update Date | 2024-08-19 |