| NPI | 1437555497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMAS V FACTORA Owner 239-267-2525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME53635) |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2014-11-18 |