| NPI | 1114310851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE CELESTE BURNS Pediatrician/Owner 386-532-0800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL 255837800) |
| Enumeration Date | 2015-03-05 |
| Last Update Date | 2015-03-05 |