| NPI | 1104658103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA TILUS Owner 407-844-9440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-08-17 |
| Last Update Date | 2025-03-08 |