| NPI | 1255827226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EILIS CLARK Mgrm 352-631-7460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2020-01-04 |