| NPI | 1225380504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON BURRESS Practice Administrator 352-259-7994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 202K00000X |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2012-10-11 |