| NPI | 1487190609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAPHAEL BONES Owner 407-509-3421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME116549) |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2017-01-11 |