| NPI | 1154424703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL L GINGRAS Vice President 239-598-3131 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207T00000X Neurological Surgery |
| 207R00000X Internal Medicine | |
| 207X00000X Orthopaedic Surgery | |
| 363L00000X Nurse Practitioner | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2013-04-22 |