| NPI | 1477866804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROMEO A TAGALA Owner/Physician 863-644-6608 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME33472) |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2014-03-06 |