| NPI | 1295106334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA CHRISTINE TROUT President 321-662-2043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME94271) |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2023-03-07 |