NPI | 1336836949 |
---|---|
Entity Type | Organization |
Authorized Contact | TERRANCE MORTON Cmo 407-607-4835 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
Additional Taxonomies | 1041C0700X Social Worker Clinical |
207Q00000X Family Medicine | |
207R00000X Internal Medicine | |
363LF0000X Nurse Practitioner Family | |
363LG0600X Nurse Practitioner Gerontology | |
Enumeration Date | 2023-04-24 |
Last Update Date | 2025-08-25 |