| NPI | 1437449592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TABITHA LANEE ROBERSON Owner 352-304-5990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9283760) |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2011-11-06 |