| NPI | 1356811897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CORDDRY Owner 407-622-8086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0805X |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine |
| Enumeration Date | 2018-11-27 |
| Last Update Date | 2018-11-27 |