| NPI | 1093862823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN MCGINLEY Office Manager 407-478-0205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME0044761) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-08-22 |