| NPI | 1508114133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIDI A ELALAOUI Md 407-343-1284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME0074304) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2012-08-29 |