| NPI | 1225199482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICK PALMON Medical Director 239-768-0006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 1279) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2008-03-03 |