| NPI | 1467728857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKSHMI BUSHAN Owner 239-275-5339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME57213) |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2012-03-29 |