| NPI | 1356027221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHUONG TRAN Owner 407-580-5453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2023-07-12 |