| NPI | 1427548304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANAND RAJ MAHADEVAN Owner 239-772-0111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| 363A00000X Physician Assistant | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2018-05-16 |