| NPI | 1265366736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHIGUETTY CHARLES FORTUNE Owner 239-244-7518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2026-06-10 |
| Last Update Date | 2026-06-23 |