| NPI | 1235165531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILY TRAN Doctor 352-323-8868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 845) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2014-01-09 |