| NPI | 1124040241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESE ANN TAYLOR President 239-540-9918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: FL ME92674) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2010-08-02 |