| NPI | 1134730864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LA TOYA DAWSON Billing Director 352-231-7551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2020-09-21 |