| NPI | 1336800721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY L GONZALEZ President 239-319-3933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2022-01-07 |
| Last Update Date | 2024-01-23 |