| NPI | 1467635581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE A MECKSTROTH Administrator 239-449-4945 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 1283) |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2007-12-12 |