| NPI | 1093963050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNARD H. BALLOU Physician 352-331-6410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0049070) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2011-09-05 |