| NPI | 1255621801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN P MONHOLLON Owner 941-955-6220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: FL ME93678) |
| Enumeration Date | 2011-04-17 |
| Last Update Date | 2011-04-17 |