| NPI | 1316388978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL G SANDBORN Medical Director 386-445-9444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: FL HCC9168) |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2013-07-11 |