| NPI | 1447211925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS R RENSHAW Owner 352-686-3154 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 20050027523) |
| Enumeration Date | 2006-04-01 |
| Last Update Date | 2008-02-27 |