| NPI | 1194066761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLEY KYLE BOW CEO 407-456-4591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 363AM0700X Physician Assistant, Medical | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2013-03-07 |
| Last Update Date | 2023-10-24 |