| NPI | 1275602476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK W DICKINSON CFO/VP 407-905-8827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2022-11-14 |