NPI | 1336713700 |
---|---|
Entity Type | Organization |
Authorized Contact | ANGIE MARTINEZ Senior Credentialing Professional 407-447-7120 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 207Q00000X Family Medicine |
208D00000X General Practice | |
261QM1300X Clinic/Center, Multi-Specialty | |
Enumeration Date | 2021-05-19 |
Last Update Date | 2024-07-03 |