| NPI | 1215999164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN BOCOCK RYALS Advanced Nurse Practitioner 352-392-1161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: FL 616462) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2020-08-22 |