| NPI | 1316792070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DAVID KORANSKY Billing And Credentialing Manager 407-770-8160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2024-04-17 |
| Last Update Date | 2024-08-02 |