| NPI | 1417377813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK MAZZEO President/CEO 239-278-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 3336C0002X Pharmacy Clinic Pharmacy (Licence: FL PH29774) |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2022-06-21 |