| NPI | 1427484252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DREW-MONTEZ CLARK CEO 239-887-2648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL 10720) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2023-10-26 |