| NPI | 1285915603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADHUKAR SHRINATH Owner 352-840-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME76333) |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2018-08-02 |