| NPI | 1295486751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY LONGORIA Part Owner 407-233-5735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2022-01-15 |
| Last Update Date | 2022-01-15 |