| NPI | 1255325080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT DUANE MARTILLA Administrator 239-481-9995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 1220) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2020-08-22 |