| NPI | 1215097845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA L CRANE Owner 239-263-6766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 843) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2012-02-23 |