| NPI | 1417115528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA FERNANDES Owner 386-447-1803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ARNP9189535) |
| Enumeration Date | 2008-05-26 |
| Last Update Date | 2020-01-06 |