| NPI | 1225636905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY C YANKASKAS Managing Physician 239-275-5522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2020-10-14 |
| Last Update Date | 2020-10-14 |