| NPI | 1356860803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARK MCCOY President 352-214-7180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QB0002X Family Medicine, Bariatric Medicine | |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2021-02-02 |