| NPI | 1174924757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMAD AFZAL Doctor 352-394-3929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: FL ME72542) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME72542) |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2015-11-02 |