| NPI | 1215373675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CHEESMAN Owner 321-354-5250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS4187) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01054637A) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2013-05-15 |