NPI | 1215901723 |
---|---|
Entity Type | Organization |
Authorized Contact | VICTOR M. PANTOJA JR. Administrator 352-242-1021 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 208000000X Pediatrics |
Enumeration Date | 2006-02-14 |
Last Update Date | 2025-01-22 |