| NPI | 1083696033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY C. YANKASKAS Managing Physician 239-275-5522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2020-08-25 |