| NPI | 1104316272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA PARKER CEO 941-529-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2021-02-24 |