| NPI | 1205128642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIME DANIELS CEO 407-846-8180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME36463) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2018-06-20 |