| NPI | 1396390217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AHMED AIDOO Medical Director 407-693-0907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 208VP0000X | |
| Enumeration Date | 2019-08-07 |
| Last Update Date | 2019-08-07 |