| NPI | 1275904823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE A TROUP Manager 239-529-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL OS11799) |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2019-04-09 |