| NPI | 1366742041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET THEODORE President 813-886-0548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME 31671) |
| Enumeration Date | 2010-10-27 |
| Last Update Date | 2010-10-27 |