| NPI | 1215338025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY T JACKSON Medical Director 352-742-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS11411) |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2016-11-15 |