| NPI | 1083873897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT JOSEPH MAMONE President 407-324-5035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS6401) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL OS6404) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2008-06-16 |