| NPI | 1144682618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELENA SEVILLA WILSON Owner 239-596-7873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: FL RN3023792) |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2016-03-24 |