| NPI | 1285881946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMENIC MARINI Owner/Medical Director 386-586-4404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME80454) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2020-03-20 |