| NPI | 1295134252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON BURDZY Managing Physician 239-275-5522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2024-08-13 |