| NPI | 1295275378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVES M LAVENTURE D.O. Medical Director 386-624-7977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS7148) |
| Enumeration Date | 2017-03-08 |
| Last Update Date | 2017-03-08 |