| NPI | 1144402199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANCE J MALONEY Owner 407-701-0012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL 24866) |
| Enumeration Date | 2007-12-01 |
| Last Update Date | 2013-11-16 |