| NPI | 1477723427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARICE ELLEN DONAHUE Owner 772-532-9124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP3198122) |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2008-03-06 |