| NPI | 1427363597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA CRAIG Business Office Manager 321-952-9696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2010-08-13 |
| Last Update Date | 2022-11-28 |