| NPI | 1477266724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED REISS Owner 407-376-4976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 202K00000X Phlebology |
| Enumeration Date | 2023-01-03 |
| Last Update Date | 2023-09-16 |