| NPI | 1184801920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY JOHNSON President 863-421-9545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP1466102) |
| Enumeration Date | 2008-01-23 |
| Last Update Date | 2008-01-23 |