| NPI | 1104059005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT EVAN SPAGNOLO-HYE Medical Director 352-347-6272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: FL OS10552) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: FL OS10552) |
| 208D00000X General Practice (Licence: FL OS10552) | |
| Enumeration Date | 2009-08-26 |
| Last Update Date | 2009-08-26 |