| NPI | 1396097903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID J GREEN Owner/Physician 863-291-3732 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME0029242) |
| Enumeration Date | 2012-10-05 |
| Last Update Date | 2012-10-18 |