| NPI | 1104408228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EZEQUIELA NILDA COLUMBIE Administrator 407-913-9945 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2021-04-27 |
| Last Update Date | 2021-04-28 |