| NPI | 1376749309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROY PETER CARLSON President 352-360-3601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL CH3219) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2020-08-22 |