| NPI | 1285935213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE JORDAN Secretary 863-683-7561 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME16261) |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2010-12-02 |