| NPI | 1154582286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN KEITH HARRIS President 407-367-0742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL ME0064086) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 177336-1) |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2010-02-09 |