| NPI | 1093768137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL L GINGRAS Vice President 239-598-3131 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207V00000X Obstetrics & Gynecology | |
| 207RG0100X Internal Medicine, Gastroenterology | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2012-11-26 |