| NPI | 1205678240 |
|---|---|
| Doing Business As | GCHSWFL CHARLOTTE COUNTY PEDIATRIC SPECIALTY CLINIC |
| Entity Type | Organization |
| Authorized Contact | VIVIAN M RODRIGUEZ Credentialing Specialist 239-424-1452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-06-11 |
| Last Update Date | 2024-06-11 |