| NPI | 1407149446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONIO E TERRELONGE Medical Director 239-300-0240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: FL HCC9064) |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2011-05-24 |