| NPI | 1114064565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY S PACKER Practice Manager 407-843-8822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME-75691) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2008-05-19 |