| NPI | 1144292756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR M. PANTOJA JR. Administrator 407-518-0078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME-0074421) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2019-08-13 |