| NPI | 1275962680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PURNAMA D MADRAY Owner 352-404-7707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME85427) |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2014-02-26 |