| NPI | 1255618682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK G MORA President 239-292-9314 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9100684) |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2012-06-04 |