| NPI | 1104247865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLEKSANDR V ONUSHKO President 407-475-3367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 2083S0010X Preventive Medicine, Sports Medicine | |
| 207PS0010X Emergency Medicine, Sports Medicine | |
| 261QR0200X Clinic/Center, Radiology | |
| Enumeration Date | 2013-12-26 |
| Last Update Date | 2014-10-03 |