| NPI | 1497367577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LA TOYA DAWSON Billing Director 352-231-7551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2020-08-19 |
| Last Update Date | 2020-08-20 |