| NPI | 1184090938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE AHASIC President 239-263-3330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ME75050) |
| Additional Taxonomies | 111N00000X Chiropractor |
| 225100000X Physical Therapist (Licence: FL PT27628) | |
| 363A00000X Physician Assistant (Licence: FL PA9106306) | |
| Enumeration Date | 2015-08-17 |
| Last Update Date | 2021-09-07 |