| NPI | 1275955312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KACIAN S BROWN Owner 407-426-4800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine | |
| Enumeration Date | 2014-01-08 |
| Last Update Date | 2025-06-04 |