| NPI | 1346816030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ETHAN M SUAREZ President 407-839-7278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2021-06-22 |