| NPI | 1477870160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARA I ROMAN Registered Agent 407-739-6208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME103345) |
| Enumeration Date | 2010-04-21 |
| Last Update Date | 2013-04-29 |