| NPI | 1134213366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIEGO FALLON Owner 863-773-4700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2016-08-14 |