| NPI | 1356336705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON BURDZY President/Managing Physician 239-275-5522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2024-08-13 |