| NPI | 1356131486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA MICHELLE KING Owner 321-229-4107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| Enumeration Date | 2025-05-12 |
| Last Update Date | 2025-05-12 |