| NPI | 1184755183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACI H MARTIN Operations Manager 863-644-9800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME82770) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2019-07-19 |