| NPI | 1073515623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA C BRIJBAG Office Manager 352-597-1960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS006150) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL osoo6159) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2013-05-23 |