NPI | 1497106504 |
---|---|
Doing Business As | PEDSPLUS PRIMARY CARE |
Entity Type | Organization |
Authorized Contact | MICKELINA LAURORE Manager 239-691-5450 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2016-06-29 |
Last Update Date | 2022-12-30 |