| NPI | 1114905866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID WAYNE DOUGLAS Administrator 239-262-5757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 973) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2020-08-22 |