| NPI | 1134995830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN C AUSTIN Medical Director 863-777-2736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 170300000X Genetic Counselor, MS |
| 208D00000X General Practice | |
| Enumeration Date | 2023-12-04 |
| Last Update Date | 2024-03-06 |