| NPI | 1205872108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY KING Administrator 863-471-0786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 1179) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2013-06-06 |