NPI | 1104520717 |
---|---|
Other Name | GAPS |
Entity Type | Organization |
Authorized Contact | DACELIN ST. MARTIN Provider 352-684-8736 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 207Q00000X Family Medicine |
261QP2300X Clinic/Center, Primary Care | |
Enumeration Date | 2023-03-28 |
Last Update Date | 2023-05-18 |