| NPI | 1487981262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUE RUSSELL Executuve Director 863-688-5846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: FL 695832) |
| Enumeration Date | 2009-11-16 |
| Last Update Date | 2009-11-16 |