| NPI | 1194000554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD BRAGG President 407-805-8989 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME0065139) |
| Enumeration Date | 2011-10-18 |
| Last Update Date | 2011-10-18 |