| NPI | 1073709333 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORIJEAN FACKLER Managing Member 352-629-8088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2008-09-10 |