| NPI | 1497371108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBIE BRUNET Owner/Provider 772-837-7800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QP2300X Clinic/Center, Primary Care | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2022-03-16 |